HomeMy WebLinkAboutBuilding Permit Application 2-22-22All APPLICABLE INFO MUST BE COMr'kf_4tD FOR APPLICATION TO BE ACCEPT �s
Date: 2,, t5_^2y Permit Number a�J�' 1�
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L� Building Permit Application
Planning and Development Services V
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:
Address: IS 17 4442OLW0 D-►Z.IV(:F, 1a0WT_ fJLsJ2e_l � f -1 - 13` 1Fz
Property Tax ID #: �JLi70� 1 - 4l �-I �2Lot No. 3 Z
Site Plan Name: 05TA63 : �l�%_ WGir��� Block No.
Project Name: T 9 Ga,44&C � -DiI � 1,-vA3
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New Electrical Meter Second Electrical Meter (Affidavit required)
Additional work to be performed under this permit - check all that apply:
Mechanical —Gas Tank —Gas Piping _ ShuttersWindows/Door's _Pond
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
_ Total Sq. Ft of Construction: 1�5� Sq. Ft. of First Floor:
Cost of Construction: $ �� ODo...• �;__===' '` `,uti ities: _Sewer Septic Building Height:.'
y 8 9 �. �±j •;'Y �.' .. � #�'. �
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Name GAH 1 S -�-
Name: "IL d
Address: 1?1"7 ,.J-IAZ.
Company: EA-J. ivL-L co�rwt6MOK ��-
City:Vog^i Pie u;g, State��1
Zip Code:. 6624j2 Fax:
Phone No. E-
Address: ,07.T a4gr
City: i /', State: Y
Zip Code: 3" SZ Fax:
Phone No 777-- 264-Zsg9
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail ( rp @ L OBYYI
State or County License G
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.
DESIGNER/ENGINEER: Not Applicable
Name:/I01'�?��"�G�'�n1iL 1Q1C•
Address: ;Fro� AVV-
City: FaiiT &4cje State: -
Zip: 341'<� Phone
FEE SIMPLE TITLE HOLDER: >( Not Applicable
Name: _
Address:
City: _
Zip:
Phone:
MORTGAGE COMPANY: -Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: NNot 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 Co�unty'and posy o�i�hs,�obsite before the first inspection••If you intend, to obtain financing, consult
..;+h 1 'rZh5 3l r n n+t r o� ho.Sl rnmmanrina Urnrk nr rern.rrliri0 Vour Notice of- Commencement.
VY11 L%.0 - - -
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Signature of Contractor - or - Owner Builder as applicable
STATE OF FLORIDA
COUNTY OFF
Sworn to (or affirmed) and subscribed be o e me of �i
Physical Presence or Online Notarization
thiQp-- dayof `1-A}. 2y
Name of person making statement.
Personally Known OR Produced Identification
Type of I e tification Produced
iSIAHNA (Alan,
(Sig t e o otary Public- State Florida)
ai '=
Ca►�MlS ING
275
Deoe!nb
Commission No. (Seal)
nEXPIRES:
20,ded
711ruNcf�pPublkUr�s
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev lUI12121