HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: C9 -1 / - 020 Permit Number: �2 j2 Qa "' d
RECEIVED
Building Permit Application FEB 2 4 2022
Planning and Development Services /" St..Lucie County
Building and Code Regulation Division Commercial !� Residential per21Ni20
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IM,PROVEMENTIOCATION
Address: L.aOu.P.: /L1A-t Vt. fir+ pies. [-. L% YI6
Property Tax ID #: /41,R9 -.1'0/ - D bcP y �00 0/6 ' Lot No. / /0
Site Plan Name:_80 A40V> . S-%wi' 7t 4 in M&A' .'7t- Block No.
Project Name: dGaad iP4 r4. 4. 17'/-4L-
QETAItEDbESCRlPTlO.N
`1.G "C, 77 e.i e,4 t.. z J N L /4,_0 aE.ti t3e� o,,j
i
f New Electrical Meter Second Electrical Meter (Affidavit required)
i
w '
CONSTRUCTION=INFORMATION::
Additional work to be performed under this permit - check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters — Windows/Doors _ Pond
__Atdctric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ ad U 00 a0 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE . , a, :•;
. t...
CONTRACTOR ' - u`°
Name W.9 tyo tN.,S
Name: 7- !/�r+,1 ! lreAJ'
Address: -1-2o l 'r�,ovs:'2aA-�.. /-}-s�
Company:4;�4 o.BA
City: /::=0 State: )r-'C_
Address: �/ d-r 3
Zip Code: � V 9 Fax:
City: pilfi29.. State:
Phone No. '% 7a -- �A.v, - 'w E-
Zip Code: 3119Y4 Fax:
Mail: �"l J� i_�'/-?�1 t 1�2 . �i+r..�,4.3c'. G��ass
Phone No 772 - c�e��;k -- g rl:L7
Fill in fee simple Title Holder on next page (if different
E-Mail 4 r- 4-r'h a.✓.5
from the Owner listed above)
State or County Licensee' C_ 056 9 CP�
IIIf value of construction is Z500 or more, a RECORDED Notice or wmmencemens 15 requlreu. II
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUpPCEM,ENTAt;CONSTRUCTION LIEN LAW ylNFORMATION
DESIGNER/ENGINEER: _ Not Applicable
Name: /,�Zx-o) GW & Ai e .4f AJ(
Address: e gb m +roc-s . <5Ct..1rre_. Dry,
City: 4 v e"stP" State:.
Zip:.3y le Phone 772-,4°--29-F 7
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: — Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
Citv:
Zip: Phone:
Not Applicable
OWNER/ CONTRACTOR AFFIDViT: Application is hereby made to obtain a permit to do the work and Installation as indicated.
1 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 consu t 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 commencine work or recordine vour Notice of Commencement.
Signature ofContractor - or -Ow4"Builderag,,�pr�cable
STATE OF FLORID
COUNTY OF
Sworn to (or affirmed) and subscribed before me of Physical Presence or
Online Notarization
this AAI� day of ara 20d., by V7,,N%Q, S
Name of person making statement.
��
Personally Known OR Produced Identification
Type of identification Pr ced
(Signature of Notary Public- State of Florida)
'?4•
LUKE WALTERs
Notary
�` a� :
Public - State of Florida
Commission No. (Seal)
�p �o
`'
Commission # GG 987056
ot'a¢•,
My Comm. Expires Jul 4, 202a
Bonded through National Notary Assn.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 10/12/21