HomeMy WebLinkAboutBuilding Permit Applicationft APPLICABLE INFO MUST_ _-�;OMPLETED FOR APPLICATION TO BE A4;r,��'TED
Date: Permit Number: O�'OJ(U�
s lio i' LlCU RECEIVED
FEB 2 2 2022
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St. Lucie County
Planning and Deve(apment Sencices P n
Building and Code Regulation Division
2300 Virginia Avenue. Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address:
Property Tax ID #:
Site Plait Narne:
Project Name:
9
Commercial Residential
Yli°W�.137 !: LT
N@w E*tric§l Meter SgcQrtd EleMkol Meter (Affidavit requir0l
Lot No.
Black ivu.
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors _ Pond
�ectric ` %Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ Q0 0c)tD Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE
z CONTRACTOR;'
Nam
Nam `�
•�.
Address: In 1% 01N C__T
CQmpan .
City: t CL-9— State:
Address: !2.
Zip Code: Fax:
City: ` t
Stater
Phone No.
Zip Code: 1
Fax:
E-Mail:
Phone N '1
--
Fill in fee simple Title Holder on next page ( if different
E-Mail
from the Owner listed above)
State or County License
t
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.
DESIGNEWOR INEER:
_ Not Applicable
MORTGAGE COMPANY:
_applicable
Name: rW 4SL k I t
Marne:
Address:
Address:
City: 1Z
State:
City:
State:
Zip: ,%wj &v Phone
3—
Zip, Phone:
FEE SIMPLE TITLE HOLDER:
�t Applicable
BONDING COMPANY:
_ of Applicable
Name: Dame:
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 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 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 eppli�Ations are exempt from undergoing a hall contrurromy review: rgpm 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 lender or an attornev before commencine work or recordine vour Notice of Commencement.
Wind:'Wina:'PA bf rune
STATE OF FL
COUNTY OF_
Sw or affirn
thiay of
Name of person m
as Ago it for Owner
subscribed befor me of �hysical Presence or Online Notarization
ram. 20 by
Personally Known OR Produced Identification
Type of Identification Produced
of Notary PubliZ\State of Florida )
(Seal)
REVIEWS I FRONT I ZONING
COUNTER REVIEW
DATE
COMPLETED
=aVA' •�i� Notary Public State of Florida
Danyel Jones
<' c• My Commission GG 352016
0; Expires 07/04/2023
S REVIEW PLANS I
PERVISOR REVIEW VEGETATIE EWON I SEATURTEV EWLE I MVE
REVIEW