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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: I ._ 7 -' D ?V� Permit Number:.' ao ''16 rJ v r. ll� RECEIVED O, . li`' ° { ' = Building Permit Application JAN 0 7 2022 Planning and Development Services St. Lucie County Building and Code Regulation Division Commercial Residential Permitting 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding PERMIT APPLICATION FOR: PROPOSED IMPROVEMENT LOCATION: Address: a,30 L) R t�40 OAK A-V r F -r. ,(mil lz t C r_ I- [ . 3 it 8 1 Property Tax ID #: 3 q 0 4 +712 - 0 '0 0 f - 0 0 © Lot No. -r*Ac p A Site Plan Name: Block No. Project Name: ,S00-04a/P &f DETAILED DESCRIPTION'OF WORK! =: ,0 (J ff e 0 Al r, 047 p- S � fl � 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: r Cost of Construction: $ S; ®0 Utilities: —Sewer _ Septic Building Height: r OWNERAESSEE: CONTRACTOR:. " Name S& 0`i404 OA(iS e�,�Xs Td q Name: S!,Vo _%"1fI:�1 LScFfnf�l� Address: 4 3 0? 0 9A ai-d OA[5s A4. Company: ii � 6 b J f- -rAr. I C , City: ET Pt 0 C Iz State: r L Address: 63 e7'`( s . 'A) . P) (. j /�1� 0A f S7--' Zip Code: 3 -I f Fax: City: P %fi ✓ 8 ✓ k J Ctiz State: Phone No. % 7 Z - 3 7rD - ©3 � 10 E- Zip Code: v 3 14? 8 3 Fax: Mail: Phone No 17 Z- F- 7 �- 6 V 8 Fill in fee simple Title Holder on next page (if different E-Mail K,1 NZJ`M4) it d L . 0 a M from the Owner listed above) State or County License 74 if 2 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. I r _, . ft SUPPLEMENTAL CONSTRUCTION -LIEN LAW:rINFORMATION DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: pQ Isc e LL . Name: Address: P.O. oX 3SXS-J7 Address: City: CiAr=scsyll-Lie State: F(, City: State: Zip: 3Z bob Phone -Is —sz -331- fs13 Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: Zip: Phone: 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 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 attornev before commencing work or recording vour Notice of Commencement. C JU�u,, Signature o Contr or - or- Owner Builder as applicable STATE OF FLO1j1 A ?�• LUC-ro, COUNTY OF Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization this Z day of 75a, 4-N 20aA- by She ON-t.'n iyw1n15cln,n�-c Name of person making statement. Personally Known OR Produced Identification Type of Identification Produced 'Et, 4hL (Signature of Nota Pu is 1%4V Florida "'YPie' public State, Commission NoA �► iotRia U ion + HH 086352025 My Comm. ExPireS ; NotarY Assn. of .. h Nations. ' "bonded throu8 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 10712721