HomeMy WebLinkAboutBuilding Permit Application VOIDAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
lQ�
c y RECENED
_
O
Building PP Permit Application SEP 02 2021
Planning and Development Services St. Lucie County
Building and Code Regulation Division Commercial Residential Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
�s
Address:
Property Tax ID #: � /�' Lot No.
Site Plan Name: Block No.
Project Name:
",m�Y' .m�ii�Xn9, •n='Fl. ,vim--Ket�_ �.-�i..�'eri i^. �.4 v9e.'.Y...: ..'^s ui.`�M{n:3..:P �Si 14 .ed°U3 i'"41��.h'^$F.C'- „M �+ls` n3-.s�.�i' i°._�,. 9F '�4..x..ry :Y 'wm i;�L%v :?.4
�
GZ>
New Electrical Meter Second Electrical Meter (Affidavit required)
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ nd sip rs —Pond -
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. -of First Floor:
Cost of Construction: $ Utilities: _ Sewer _Septic Building Height:
x55� .. �CT t'dz'tl
>� � .
�'"r+
at
i4E«T.M..4'ht.'•., fa_8'.rsu.x ,,. Si^ '* #°-w'P.:. _: -P. rx� .. Yy .n :s.:,iq^10.J�
Name/�� iSLs�7`it Name:
T
Address: Company:
City: ^— ?� State Address:
Zip Coder' Fax: City: State:
Phone No. 1 Zip Code: Fax:
E-Mail: Phone No
Fill in fee Sidple Title Holder on next page ('if different E-Mail
from the Owner listed above) State or County License W I a
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
�t
DESIGNER/ENGINEER:
_Not Applicable
=;i
AG ;COMPANY: _ Not Applicable
et.
Address:'"
�Ad"ress:
City:
State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER:
_ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the worK and installation as inaicatea.
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 is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners 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 propertyt. 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 attorney_befor6�-commencing work or recording our Notice of Commencement.
Si tur wne'L&s'sdeWnFfct6ir as Agent for Owner
STATE OF FLORIDA
COUNTY OF L,,c e
Sworn to (or affirmed) and!subsc�ibe'Pbefore me of " Physical Presence or Online Notarization
this day of >�, ? ; 20 ° Z.(by
Name of person making statement
Personally Known OR Produced Identification
Type of Identification Produced Tf/
(Signature of Notary Public -State of orida) HEAate THER t3Ur"vpubli
otary
SComm'ssion # GG 183217
Commission No. (Seal) N PQ My Oommiss,on Expires
February o! P�
';1O11110�`
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION
COUNTER REVIEW REVIEW REVIEW REVIEW
DATE
REC5IVEb
SEA TURTLE I MANGROVE
REVIEW REVIEW