HomeMy WebLinkAboutBuilding Permit ApplicatonAll APPLICABLE INFO MUST BE CWvrrLETED FOR APPLICATION TO BE ACCEPTEL4
Date: I g I &? Permit Number: Duo& 0
1�r
O �.� RECENED
° Building Permit Application
FEB 0 4 2022
Planning and Development Services
Building and Code Regulation Division Commercial Reside?ttW Coin/
rnittlfl9
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: V798 NW C;nnaronn W&V
PropertyTax ID #: Lot No.
Site Plan Name: &Arrec- VAete-e- V"cxAr iftd6 -PLA7 3 ` U^Or 3$ Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
New Electrical Meter
Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: 6qyPO'
Cost of Construction: $ 1(o "d
36419 --18i
(Affidavit required)
_ Generator
Sq. Ft. of First Floor:
Windows/Doors _ Pond
Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWN,ERAESSEE:
CONTRACTOR:
Name G ;C' lmkES
Name: _'yLrr►e5 (Toc Cmi t
n
Company: (TC,nlnrtnft%5 5'.rder1 19 Tit Co•
Address: 70, 15ox 5_RS
Address: 1a796W A CAnnAoiw u6y
City: I�C.�M cif State: rL
City: Jensen State: F.
Zip Code: Z4g46 Fax:
Phone No. (('7'7o'i 40' i - iDR%O E-
Zip Code: Fax:
Mail:
Phone No7'7o?-a80-0(nfb5
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail (_qx nm n . $creer� p ��ur� . C o✓►1
State or County License Cb mA�
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: LLC. Name:
Address: 4 Address:
City: State: FL City: State:
Zip: 3345a Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
Not Applicable I 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 Ipndpr-nr an attornev before commencing work or recording vour Notice of Commencement.
Signature Cont actor - or - Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF !I-;T. WL TT� Coo N:K' J
Sworn to (or affirmed) and subscribed before me of Zo Physical Presence or Online Notarization
this — I+— day of &%A_)O A 20oA.")-by
Name of person making statement.
Personally Known OR Prod ced Identification
Type of Identification Produced ill
(SigJer p#y� fvFlfl )
Notary Public Ste of Florida
M Snyder
Corn l Cassea
�aw�. E-�-c�0211�59axs'
R
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Rev 10/12/21