HomeMy WebLinkAboutBuilding Permit Application 2-15-22All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 21 �� �'� Permit Number:acl
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial _X Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: �E C
ram`'
IPf,°=POSE'DIMPROVEIVIE,NT�LOGA�TIO,N4a.�°�.s.t�`
Address: 5990 Emerson Ave Ft. Pierce FL 34951
Property Tax ID #: Lot No.
Site Plan Name: Lakewood Park Block No.
Project Name:' Lakewood Park Regional Park
G
New Electrical Meter Second Electrical Meter.
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters
(Affidavit required)
Windows/Doors _ Pond
_ Electric —Plumbing . —Sprinklers _ Generator _ Roof I Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 99,990 5600•� Utilities: _Sewer _Septic Building Height:
t ij Y }l;rt „ty i t-Sij3'S �#
OWNER/LESSEE , ��,M s ;�� ; , a �1 CkCONTRACTOR
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Name 54-, �GtCL/•e �� +,r �i
Name: Zach Stevenson
Address: -j _( i AIN "e
Company: Nidy Sports Construction
Address: 751 General Hutchison Pkwy.
City: Tk —� Stater
City: Longwood State: FL
Zip Code: Fax:
Phone No. E-
Zip Code: 32750 Fax:
Mail: s .sf�-�*�,e✓P� �S� C' i� C'�,�1`�
Phone No 407.205.3778
E-Mail Jpapp@nidycompany.com
Fill in fee simple Title Holder on next page (if different
State or County License CBC 1261000
from the Owner listed above)
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.
:SUPP..LEMENTAL'CO(VSTRU:CTIONr(IEN' LAW INFO' IMATION:
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: N/A
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 attornev before commencing work or recording vour Notice of Commencement.
Signature Contractor - or - Owner Builder as applicable
STATE OF FLORIDA II
COUNTY OFF e to t11C l
` /
Online Notarization
Swornt��,,(or affir ed) and subscribed before me of i� Physical Presence or
his tf D`�day of� f f 2Q_P
Name of person making statement. Z a-c-A— S
Personally Known OR Produced Identification
Type of Identification Produced
(Signature of Notary Public- State of Florida)
Commission No.-ii (Seal)
�tiPpYPVB�i MICHELE KEMP
�a° Notary Public -State of Florda
=• •= Commission N HH 40033
;�fa,�°P•� My Commission Expires
September 07, 2024
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