HomeMy WebLinkAboutBuilding Permit Application I
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3 8 a`-z" Permit Number:
RECEIVED
oCl1L� � j l MAR 2 5 2022
m y
Lucia county
Building Permit Application
Planning and Development Services
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: S'
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IRV»? 1 ¥ RAN-, y
Address: !0,2 6 T-P 905PF PIS-AN, F6iZT /_
Property Tax ID#:_L3(/f �j f/ " C/,2 9J y Lot No.��
Site Plan Name: �p Block No. �
Project Name: N11YA
On
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!Z or- r r : 1W C-96, Lu�bs % G�/dR aft Ir
New Electrical Meter v0 Secon 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 _Roof Pitch
Total Sq. Ft of Construction: AO 4i= Sq. Ft.of First Floor:
Cost of Construction: $ 196v®00 Utilities: _Sewer _Septic Building Height:
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Name M�11-nI(� e '�YZ i��:1�1q Name: 1 1
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Address: 3D /. S n�r►�- f.05A Pt-VwY Company: 2706 KRANTIC AVENUE
City: (�1 State:_ Address: eADT DIGD�C CI 44947
Zip Code: Fax: City: State:
Phone No. 18 " j J 13 E- Zip Code: Fax:
Mail: iM i%b l9l C k I5"fM IF i'l-on .4 Af"11 rLO Phone No
Fill in fee simple Title Holder on next page(if different E-Mail 1 rc,5 0 un.S t r 4c r N,0 � A.0 l
from the Owner listed above) State or County License L�'G 15-14Oq 3-
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 MPA Y: _Not Applicable
/ pp MORTGAGE CO
Name: Name:
Address: Address:
City: State: City: State:
Zip: hone Zip: ';Phone:
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FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address: 1
City: City: a
Zip: Phone: Zip: Phone:
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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:roo 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.
Sig a re o Contractor-or Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF
Sworn to(or affirmed)and subscribed before me of Physical Presence or Online Notarization
this day of Tv%44 20��by
oy,
Name of person making statement.
Personally Known OR Prod ed Identification
Type of Identification Produced L L
(Signature of Notary Public-State of Florida)
Commission No. DEANNA GIVENS
tiY°oe''
Notary Public State of Florida
Commission HH 085352025
:r�pv tiR:• My Comm.EXPires Jan 28.tary Assn.
ou h National No
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE {
RECEIVED J
DATE
COMPLETED
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