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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR'AFPLICATION TO BE ACCEPTED Date: Permit Number: QL O 91r. [L CHIE ;ZA-1 RECEIVED Building Permit Application JAN 2 1 2021 St. Lucie County Planning and Development Services Permitting Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: Commercial CBDG Funding PROPOSED IMPROVEMENT LOCATION: Residential Address: =2703/✓. OL141C 110�641"sal) /s1z-d?d, FL, 341W Property Tax ID #: /'/ Zg - 7j91- A) f e� - 2�" CLot No. '16 Site Plan Name: 62S'ig j ) c«► ® Block No. _7 Project Name: C cts 4-cu'a-lb I`DETAILED DESCRIPTION OF WORK: New Electrical Meter Second Electrical Meter (Affidavit required) CONSTRUCTION INFORMATION: Additional work to be performed under this permit- check all that apply: Mechanical _ Electric Gas Tank Plumbing Gas Piping _ Sprinklers Total Sq. Ft of Construction: 3Ct D Cost of Construction: $ Shutters Generator �ndows/Doors Roof Sq. Ft. of First Floor: Utilities: —Sewer _Septic Building Height: Pond Pitch OWNER/LESSEE: CONTRACTOR: Name 09 �c�� a�.n-c> Name: L� Address: 2 703 ;1. - City: Zip Code: 34f 9 L 1 Fax: Phone No. % 7 S ' n1 —E State:L 1 k,0 -1 E- Company: Address: %20- City: n n,r� S�-1 Qx 1i/� State: Zip Code: 3'ZgT Fax: Phone No_ 1 ,77-7 , !:7--�&.t-p-171,2 , E-Mail cS &Jz . eA VY'1 State or County License C8,e- I5thu LO Co % Mail: :%e-/z. W •Co ryl Fill in fee simple Title Holder o xt page (if different from the Owner listed above) 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. W) 'SUPPLEMENTAL CONSTRUCTION IIEN LAW INFORMATION: _ DESIGNER/ENGINEER: _VNot Applicable Name: _ Address: City: Zip: Phone State: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: -Sa vy k Address: City: Zip: Phone: MORTGAGE COMPANY: Name: Address: Citv: Zip: Phone: 1sNot Applicable State: BONDING COMPANY: V 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 lender or an attorney before commencing work or recording our Notice of Commencement. Signature of Contractor - or - Ow r B ilder as applicable STATE OF FLORIDA �l COUNTY OF �h5 1�/ y4 3 Swor to (or affirme ) and subscribed before me of't: this 7-(9 day of 2022lay hysical Presence or Online Notarization Name of person making staters Personally Known OR Produced Identification Type of Id tification Produced (Signature of Notary Public- State of Florida) Commission No. Yy ©) D q 2 3(Seal) ?4evc SHERI L.000K 2o'49 * * Commission # HH 010423 N� Expires June 22, 2024 \oe �c . ' Bonded iluu Budget Notary Senim REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 1U/12/21