HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMP.:.-'.fD FOR APPLICATION TO BE ACCEPTED
Date: 2 O � • Permit Number"20a . 0 D-) V.
9�o dUME
Planning and Development Services
RECEIVED
Building Permit Application FEB 0 8 2022
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
St. Lucie County
Permitting
Commercial Residential ✓
CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION: - - - - -
Address: 16113 -Pi L IL. f-L- .3J 98,Q
Property Tax ID#:J*D �2_- to DOD Lot No 2 �3
Site Plan Name: ('5 11 _3 M 7D R_ Block No. 45
Project Name: 1_:�) i LLt s �5 1 li✓i� C�
DETAILED DESCRIPTION OF WORK:
�_W L M L 0.0 ML i P'ft0_?I o 0 � .� 66bP_ooNLs � iiS H-Rooms 4eAC
G AreP�. C? C-_
New Electrical Meter ✓ Second Electrical Meter.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
-/Mechanical _ Gas Tank _ Gas Piping _ Shutters
(Affidavit required)
✓Electric ZPlumbing _ Sprinklers _ Generator
V Windows/Doors _ Pond
✓ Roof 4, Pitch
Total Sq. Ft of Construction: 3491,
Sq. Ft. of First Floor: -3
?
Cost of Construction: $ 31 Q;
000.yo
Utilities: _ Sewer ✓Septic
i
Building Height: .23
OWNER/LESSEE:
CONTRACTOR:
Name S-I:: ag rj � -x�-I✓I3pr-,! N A
Tp i L L I
Name: n w N i✓�
Address: 5513 3PR LLO-k _JD 2.
Company:
Address:
City: 5v k i A fir? r? g-- State: rL
Zip Code: 3-f UA Fax:
City: State:
Phone No. ''r1 a -S I Q - d-A 036
E-
Zip Code: Fax:
Mail:7:1:) A C',iZ.�\ & :f)P LLS D L i
Phone No
Fill in fee simple Title Holder on next page (if different
E-Mail
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: � ��E! Cli �Tec,To n�
/,/7c .
Name:
Address: ,,s ge e f- Ve-
Address:
City: � r f' , r ,e c e—
Stater
City:
State:
Zip: ,:� gys"o Phone 772 2
6
Zip: Phone:
FEE SIMPLE TITLE HOLDER: f
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.
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 your Notice of Commencement.
0 �- /.
42A�/=4
Signature ofW tract r - or - Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF —Ie ,
J4.
Sworn to (or affirm-,') and subscribed before me of Physical Presence or Online Notarization
this-- day of gi,,6 20-2) by
Name of pe on making statement.
Personally Known OR Pro uced Identification
Type of Identification Produced i
(Signature of Notary blic- State of Florida)
o,c;
AUDREY B. HUMPHREY
Commission No. (Seal) ;,; ,-
MYcoMMISSION#GG300817
:9r
EXPIRES: March 6, 2023
Bonded Thru Notary Public Underwriters
aL¢o7+s
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