HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
llo [LU1IQM-F J�" RECEIVED
Building Permit Application MAY 0 5 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 Cl3DG Funding
PERMIT APPLICATION FOR:
PROPOSED
tb IMPROVEMENT b ENT,---! LOCATION
Addre'ss: jOZE/ 5 Qceal7 ):�-ccwe r3-6
Property Tax ID #: 601-910 Lot No. 96
Site Plan Name: ve/7�-C' P, C, r Block No.
Project Name:
[DETA -I,LE'Db'ESNIPTI., R.bf'-W OR
il-� L0 a7f lzoy �9,!P
New Electrical Meter Second Electrical Meter (Affidavit required)
'IN:FORMATI
CONSTRUCTION
ON
�
Additional work to be performed under this permit -check all that apply:
—Mechanical Gas Tank —Gas Piping Shutters
Electric Plumbing Sprinklers Generator
Total Sq. Ft of Construction:
Cost of Construction: $ (;
Sq. Ft. of First Floor:
.1 1
Windows/Doors
Roof
I
Utilities: — Sewer _Septic building Height:
i
Pond
Pitch
'0 WNtk/LEs5'Et
T
Name 0k
Name:
Company:
Address:
Address: pia-s.
City: State:zVl-
Zip Code: 0 9,/ Fax:
Phone No. 73.7- - 645-'o — E-
Mail: 2 5 A i Q- 00 rO, 1-7/,Al e - /7 7-
City: State:
Zip Code: Fax:
Phone No
E-Mail
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License
Ifvalue 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
1.
DESIGNER/ENGINEER: :-Not-Applicable. MORTGAGE COMPANY: _ Not Appticabte
Name:
Name:
Address:
Address: 1
City:
State:
City: State--:
Zip: Phone
Zip: !Phone:
I
FEE SIMPLE TITLE HOLDER:
Not Applicable.
-BONDING COMPANY: _Not Applicable
Name:
Name:
Address:
Address:
City:
City:
!
Zip: Phone:
Zip: ;Phone:
l
a
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 mayl 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 iAmendments.
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 �paying1wice for
improvements to your property_ A Notice of Commencement must be recorded �inthe. public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
:+L. 1-4—,. 1++,,1-1 L,l.Fr..r nnmmonrinrr urnrlr nr rarhrriinamni Ir Mntirp nf1('nmmPnrPment_
Signature o Contractor - or- Owner Builder as applicable j
STATE OF FLORIDA
COUNTY OF �� • 1.;Qe j
Sworn to (or affirmed) and subscribed before me of Physical Presence or' Online
Notarization
this S day of 2Wp by
Name of person making statement. ! i
Personally Known OR Produced Identification .
Type of Identification Produced
DEANNA GIVENS
(Signature of Nota Public- 'riN ryu c- a
a° Cteofrtull
HH 086359
ommission
25
' My Comm. Expires Jan 28, 20sn
��,�� National NotAssn.
Commission No. "tfi6' ded through
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i
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS-
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev 10/12/21 ,