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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: -3 Permit Number: L-LI��L_= - �' Building Permit Application Planning and Development services Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue, Port Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding PERMIT APPLICATION FOR: C14k tA,S G ' ,1 LLN(� fe+`1G-f s (ems PROPOSED IMPROVEMENT LOCATION: Address: Property Tax ID #: 0 3 1.L � ©� � Lot No. Block No. Site Plan Name: GOO Fs� LAN Project Name: DETAILED DESCRIPTION OF WORK: LIM GL03P.; ( [•tiL New Electrical Meter �� Secand Elec#rical Meter (Affidavit required) CONSTRUCTION INFORMATION: Additional work to be performed under this permit- check all that apply: Mechanical Electric Gas Tank Plumbing Total Sq. Ft of Construction: Cost of Construction: $ 1- L n D• o 0 OWNER/LESSEE; Name./ • e Address: (0-1 t City: Gas Piping Sprinklers State: _ Shutters Windows/Doors ^ Pond Generator , Roof Pitch Sq. Ft. of First Floor: Utilities: _Sewer tzSeptic Zip Code: `� Fax: Phone No. r7')2 321 " _2SS" 7 E- Mail: O G� Fill in fee simple Title Holder on next page (if different from the Owner listed above) CONTRACTOR: Building Height: Ant Name: t ' Company: vG,ha� Address: t"� '?Tz—U�•��A� �� rTP fo City: (1 P,c2�_1� �� State: Zip Code: _ 22r1 Ce 3 Fax: r Phone No_"72 E-Mailovhie, e d Ar^ CG State or County License '�-_ If cement is required. value of Construction is Z500 or more, a RECORDED Notice of Commen if value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL.CONSTRUCTION LIEN LAW INFORMATION: - A Ibl DESIGNER/ENGINEER: — Not ApplicL� G Name: KE r Lc, zO 1 Add ress: City: ed-0 434A State: Zip: Phone?72 '77o - ql' FEE SIMPLE TITLE HOLDER: Not Applicable Name: Address: City: Zip: Phone: MORTGAGE COMPANY: Not pp Ica e Name: Address: City: State: Zip: Phone: BONDING COMPANY: -4Not Applicable Name: _ Address: City: Zip: — Phone: OWNER CONTRACTOR AFFIDVIT: Application is hereby made to obtain a per 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 an 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 Couryan posted on the jobsite before the first inspection. If you intend to obtain financing, consult with_le➢r�r op4 attorney before commencing work or recordi Ig your Notice of Commencement, Of ntractor - or - Owner Builder as applicable STATE OF FLORIDA�_r COUNTY OF.+C� Sworn to (or affirmed] and ubscribed ZD?-2-bY of Physical Presence or_ Online Notarization this L day of Name of petfson making statement. OR Produced identification .P�t� �� ZAVAI0HH1t}iST Personally Known MISSION HH 176387 Type denI icatia,+ijProdyCed;opl�g;$ep�embert9 2025 n �� jj /� n��"o```"P., 3=W � �r P&k urn (Signatu o f Not r u e of Florida) No. Y�?'-7 (Seal) REVIEWS I FRONT COUNTER DATE RECEIVED DATE ZIDNINO REVIEW y 5 REVIEWOR REVIEW PLANS IVREVIEW EGETATION S REVIEW REVIEW MANGROVE EVIEW