HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONINFO MUST BE COM:-C2i'Lu eOR APPLICATION TO -BE ACCEPTED
Permit Number:
RECEIVED
FEB 16 2022
° .. - - Building Permit Application st,,1gipcounty
Planning and Development Services Permitting
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROP, OS;ED, 1MP.ROVEMENI' LOCATI_QN t_
Address: �� fr7�• Lt%/1 L%/'—' /y U�
PropertyTax ID#: �301-�\a►'aag�—Odo Lot No. i 3
Site Plan Name: Block No. /o_la
Project Name:DLAt-7C . r Soi-+ C. L Jry%A1,J
_.
DETAILED. DESCRIPTION,.OF WORK:: .
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION IN:FOR;MATION
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
Windows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: ,tVZ VEAPW \61b Sq; Ft. of First Floor:
Cost of Construction: $ Sr Ova • Utilities: —Sewer* —Septic Building Height:
OWNER%LESSE'E
CONTRACTOR:'
Name taw /l/-� �f U� owrl'i'A
° Name:
Address: O .a/ /�
Company,
City: t rre State: )ct
Address:
Zip, Code: 33/9S/ Fax:
, City.: State:
.Phone No. 4 ~ 5777— 93-S- E-
Zip Code: Fax:
Mail: Air ow,4N prC J 4Y V c,i11A
Phone No
Fill in fee simple Title Holder on next page (if different
E-Mail
from the Owner listed above)
State or County License
IIf value of construction is 2500 or more, a RECORDED Notice of Commencement is required. I
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is, required. "
DESIGNER/ENGINEER:
Name:
Address:
Citv:
Zip: Phone.
FEE SIMPLE TITLE HOLDER:
Name:
Address:
Citv:
Zip: Phone: _
_ Not Applicable
State:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name: _
Address:
City: _
Zip:
Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby.made.to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attornev before commencing work or recording vour Notice of Commencement.
x, A
ignatu Contractor - or - Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF S)Ii,. "- ,ek
Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization
this C� L day of VvA- , 202,aby
Q 1� \f'�'� �Crw ►tiq'�
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification Produced T__L. >DL
(Signature of Notaiq Public- State of Florida)
Commission No. aAkrs3 711— al) DEANNAGIVENs
Notary Public - state of Florida
c�a Commission q HH 086359
'`�'ci' Expires Jan 28, 2025
My Comm.
of F`s• Assn.
Bonded through National Notary
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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DATE
RECEIVED
DATE
COMPLETED
Rev 10/12/21