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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: - )7 22 Permit Number: `� �• L• rc.'LMAR ] 7 2022 P L- C L L•L --� St. Lucie County Building Permit Application Permitting 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 PERMIT APPLICATION FOR: . 4/ 1L1 J,,9 4�.v -PROPOSED IMPROVEMENTIOCATION: Address: Property Tax ID #: Site Plan Name: Project Name: Lot No. I Block No. J6 ( ;DETAILED -DESCRIPTION, "OF WORK: I ©iI/tz 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 �I _ Electric _ Plumbing _ Sprinklers _ Generator J- Roof `3 Pitch Total Sq. Ft of Construction: c�,� 5q. Ft. of First Floor: 0 Cost of Construction: $ / C7, " 19• 0 Utilities: —Sewer —Septic Building Height: f� OWNER/LESSEE: .CONTRACTOR: *. Name e, % Name: Address: (d diof pi, A&X Company: City: #41vX r? 9&,C,`J Stater Address: Zip Code: 3 �` � �� Fax: City: State: Phone No. 229, -394) Zip Code: Fax: E-Mail: 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. PeSvruj �>� SURRLEMENTACCONSTRUCTION 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: Act 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 Is in conflict with any applicable Home Owners Association rules, bylaws or andcovenantsthat may restrict or prohibit such structure. Please consult with your Home Owners 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. SidqatOe of owner/ Lessee/cdntr6itor as Agent for Owner STATE OF FLORIDA COUNTY OF LAG 1 E Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization this /I) day of 14 4 f-G H 2012 by Name of person making statement. Personally Known OR Produced Identification x ' Type offi%identification Produced /% !b A_ IF A DIV Vi LI cE.US� iG-a (Signature of Notary Public- State of Florida ) d�//V G�7 U (Seal) Commission No. Seal j�sY x��4' MATT WILHELM 1�' .ate,?^.`: Notary Public -State of Florida 'j Commission M GG 278734 of? My Comm. Expires Nov 25, 2022 Bonded through National Notary Assn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE DA