HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: j1aS13`a. Permit Number: aQ•631 "61M J
O.L}o.ILU11 l 'u.' RECEIVED
MAR 2�5 2022
Building Permit Appflcati®nst,I,,,.I,,,qun,Y
Planning and Development Services Perrn
jtting
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone:'(772)462-1553 Fax:.(772)462-1578 CBDG Funding
PERMIT APPLICATION FOR
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Address:_
Property Tax ID#s 23 L73 (ti{ l ��_p�r (�fj (� I Lot No.
Site Plan Name: Gr ou -a j Block No.
Project Name: j
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New Electrical Meter Second Electrical Meter (Affidavit required)
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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_ g _ p �Roofs .Z !Z Pitch �
AVP (�/lz duo
Total Sq. Ft of Construction: (000 Sq. Ft.of First Floor:
Cost of Construction:$ 22 Soo- Utilities: —Sewer _Septic Building Height: STo�
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Name TOtW 4 Lycc j5.-� obepv, Name:,.
Address: �(
L_(o S. ,Tc tilc.wS FZ--0 Co "A
City: t=f t 6CO2'6s' Stater "Address:"'32`7,1,
Zip Code: 31-11't`Z Fax: City: i� �cL G = State:r�
Phone No. -7-1-7 L4n 4 3[57 2 E- Zip Code: 3Lff k 7i !Fax:
Mail: Phone No ' '72,, 2tG
Fill in fee simple Title Holder on next page (if different E-Mail
from the Owner listed above) State or County License�'�'LpSSS')�3 �G7�
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.
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DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable ble
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Name:
Name:
Address: .Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: —Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
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 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 a ost d on bsite before the first inspection. If you intend to obtain financing, consult
with le r an at e before ommencin work or recording our Notice.of Commencement.
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Signature of Contractor-or-Own eras applicable
STATE OF FLORIDA
COUNTY OF
Sworn to(or affirmed) and subscribed before me of Physical Presence or Online Notarization
this'4,5 day of 200-'a'by
�N t-� Q fN (wb-�to-r'W,"
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification Produced
(Signature of Notary ublic-State of Florida)
�iVENS
Commission No.N H6�
..NSeal DEANNAstate of Florida
� N)tary P fission HN 086359
�\<: Comm ires Jan 28,2025
7 �F My Comm.ExP Assn.
or F.• h National Notary
Bondedthroug
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 10 2 21