HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED `'� r ,,
Date: Permit Numbe3a _ O I �(!
RECEIVED
u U°a L' Lall MAR 2 3 2022
Buildin Permit Application
g St. Lucie County
Planning and Development Services Permitting / _
Building and Code Regulation Division Commercial Residential �/
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462=1553 Fax: (772) 462-1578 CBDG Funding
Address: a3 yo
Property Tax ID #:
Site Plan Name:
Project Name:
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New Electrical Meter Second Electrical Meter (Affidavit required)
Block No.
Additional work to be performed under this permit — check all that apply:
Mechanical _ Gas Tank —Gas Piping —Shutters _ Windows/Doors'-' — Pond,,
_ Electric _ Plumbing _ Sprinklers _ Generator — Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
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Cost of Construction: $ Utilities: _ Sewer _ Septic Building Height:
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Name r lQ 0 /1
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Add ress: 9� �1 0'S'FO
City: F"E - pt-cnce-
State``,c.,, .
^Address: `3a?/ /7 i
City: F-F•P/ erY?
State: F�.`
Zip Code:3HFax:
Phone No.77) ' 92 9"-7161—
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Zip Code: 3y�BZ // Fax:
Phone No 7 *2a-
Mail: 91MpSon%rioing xjISpyth • n4-+-
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Fill in fee simple Title Holder on next
page (if different
E-Mail
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from the Owner listed above)
License_ S'f .�r�Qy
State or Cou` ty2cec
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If value of construction is 75UU or more, a KtLUKUtIJ NOUCe Ur Wfia I luI RAVIlul 14 a� i c4uu I
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
Name: �t'-E�'l�/'`ir'�C��i�
C�1 �
Name:
Applicable �;''"
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Address:
AVE
Address:
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City: F� (�� ��c2GP Stater
Zip: Phone 77� �{�G 7
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY:
Name:
Not Applicable .
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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OWNER/'CONTRACTOR AFFIDVII: 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 rep resentation'thaf is granting a permit•will abthoriz�e the permit holdelqto build the subject 1. st'ruct4e
which conflicts with any. applicable Homeowners Association rules, bylaws or and covenants that may:Festrict 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 con �cur(ency review;-rco'n.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 jo'bsite�before-the..first inspection. If you:intend ,to,obtain financing,, consult
with lender or an attorne before commencin work or recordin our Notice ofi,Comrh cement.
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not
IuAm-e&
/
Signature of Contractor - or -Owner Builder as applicable
-
STATE OF FLO�:Q�l
COUNTY OF c� LLkr��,
Sworn to (or affir d) and su scribed before me of ✓ Physical Presence or Online
Notarization
this � day of 20�y
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Name of person making statement.
Personally Known