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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE CON.. ti�TED FOR APPLICATION TO BE ACCEPTED ` Date: 3���`�� Permit Number: a`-zo3-cry `F' RECEIVED 0 h1 U MAR 16 2022 Building Permit Application St. Lucie County Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: PermittinqK— Commercial Residential CBDG Funding PROPOSED IMPROVEMENT LOCATION: acfdresO ST f^V' • �^ 1 F " qg Property Tax ID#: ')AOC\ S�3" �`Q �'�'d d" Lot No. Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION OF WORK: New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: (Affidavit required) 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 S'q "Ft;of'Constru� ctionV --Cost'of�ConstrucfionDo 0 Sq. Ft. of First Floor: Utilities: —Sewer _Septic Building Height: TWINER/LESSEE: CONTRACTOR: rName o r vvk&c1 % o le Name: Company: Address: q � ' r-V- City: Fy'c- �P State: f�— Address: ip Code: 4q'D_ Fax: City: State: No. _ 1 —7fo E- Zip Code: Fax: r-Phone I! ail: © Pi tie -CL`f tfl iP Phone No E-Mail FulL,,t n fee simple Title Holder on next page (if different fr he Owner listed above) State or County License 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 Name: Address: City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: Zip: Phone: MORTGAGE COMPANY: Name: Address: Citv: Zip: Phone: _ Not Applicable State: 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 anyapplicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such structure. Please consu t 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 lender or an attorney before commencing work or recording our Notice of Commencement. L�- V� iafQ Signature of Contractor - or - Owner Builder as applicable STATE OF FLOTDA COUNTY OF k . L" -� �e Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization this _S day of N\6-N 20�* by t' a6-%4�- b' Q�rra\1 Name of person making statement. Personally Known OR Produced Identification Type of Identification Produced (Signature of Notary blic- State of Florida) o Commission No.\-\ �a�� ea DEANNAGiVENS Florida Notary public State '=t��•��"���` # HH 086159 6352025 i� Expires Jan 28, a oQ•' AV Comm. tar Assn, `P.f. h National Notary • " Bonded throng REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev