HomeMy WebLinkAboutBuilding Permit App All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: RECEIVED Permit Number: J� `1
9`T. MAR 3 0 2022 RECEIVED
St.Lucie County
U h o a ° -° "�� Building perm it Application MAR 1022
Planning and Development Services St.Lucie Coun
Building and Code Regulation Division Commercial Residential Fermi in
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: Lan\95 '��r v�St�v� cC' DDC� bu[_52.,
Property Tax ID#: ]— d Lot No.
Site Plan Name: `ZG' WI' : Block No.
Project Name: &C-0t:!lf (_&—A
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 —Gas Tank —Gas Piping _Shutters _Windows/Doors _Pond
_Electric _Plumbing _Sprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: ' ��� Sq. Ft.of First Floor:
Cost of Construction:$ )6) p&1'40-M Utilities: _Sewer _Septic Building Height: lop
OWNER/LESSEE: CONTRACTOR:
Name J rmc a,(-A 260;!!S"N zj`3@ fame:
Address: L2-1\'s mSd 'Te—f— ompany: — �e
City: P06E SJ-LuGsti State:L'Z Address: 85p N\&j r[?k2k= JL
Zip Code: BUATz— Fax: QQ City: 4�.,,r, State:
�' `
Phone No. \�"J �"e Sc> E- Zip Code: WA Fax:
Mail: If1���j�d�`"'�L�C h.,��� "t, Phone No 7i -z I
Fill in fee simple Title Holder on next page(if different E-Mail 'Ft
from the 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 MORTGAGE COMPANY: _Not Applicable
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 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-Owner Builder as applicable
STATE OF FLORID
COUNTY OF ee,
Sworn to(or affirmed)and subscribed before me of hysical Presence or Online Notarization
this A day of W,n11y3ZAa 20Z?_by lj5� vJ
Name of person making stat ent.
Person Known OR Produced Identification
Type o Id ntification Produce
2
(SiAr a re of Notary Public-State o orida)
Com ission No. Seal)
;2osP�YP�e�;N=iN
of F o/rida218518t:;•.res02^
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