HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
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: W'tnd�w yrS
PROPOSED IMPROVEMENT'LOCATION:
Address: S I Sq N (t1A -W 1 14 , �Wkc \,nson Lslavu , FL 349-19
Property Tax ID #: I`7•' I I - 706 - OQ33 - o�C- 9 Lot No.
Site Plan Name: tAakat� 12 f,t n hold Block No.
Project Name: Nkyatf
DETAILED DESCRIPTION OF WORK:
1?Cvtnovz. d- repl�rx 6 Ir�.aaC� ,.>i��cx�b -� � }rvtnAt%' car•
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters ✓indows/Doors _Pond
_ Electric - Plumbing _ Sprinklers - Generator — Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ l z3 ZOO Utilities: -Sewer -septic Building Height:
OWNER/LESSEE:
CONT '
Name Yz8 'r�hotd
Name: 4t j'tR� A . MtW M3Y\.
Address: 515CI t3 Ft1 A 3% 114
CompanyAkwAt.3n %�j'�nt♦OwS d 144bVS
City: NNLA6hiv+Son zsIarc± State: Vi-
Address: If ct hVeYLf- 1-
City: IQjvte-ya &aO- State: 'FL
ZipCode: 34g49 Fax:
Phone No. 3 31— 731 - Ic1 1 1 E-
Zip Code: 33464 Fax: 561-64d - I Oq
Mail:
Phone No SCo I - 64 0 - Loci a
Fill in fee simple Title Holder on next page (if different
E-Mail VvimAki "'y FrrlewwLan — wi naw-s. Lb rn
State or County License C6C I _S09 of 4 -1
from the Owner listed above)
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.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: I
INEER: Not Applicable I MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
Name:
Address:
City:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable I BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
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 conflictr 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 ler)der or an attorney before commencine work or recordine vour Notice of Commencement.
Signature of Contractor - or - Owner Builder as applicable
STATE OF FLORI,,)pA
COUNTY OF F6I01 tt"
Sworn to (or affirmed) and subscribed before me of ✓Physical Presence or Online Notarization
_
this 8 day of 2030,-by
C�f.P�0.P.y�. a. %IP 1fU'M;r1X\
Name of person making statement.
Personally Known t✓ OR Produced Identification
TypeofIIddeentipficca�tion Produced
�.CU:JI�-tXJ�
(Signature of Notary Public- State of Florida) ,
DAKOTALUCAS
Commission Nol� I -I" C:1+09t MY COMMISSION#HH 0"9
` _Z.' EXPIRES: June 24, 2024
W dW Tin NMary Pubk WW.* ilen
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SUPERVISOR
PLANS
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MANGROVE
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DATE
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neV 1V/14141