HomeMy WebLinkAboutBUILDING PERMIT APPLICATION 1-3-22All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: J. ze11_ Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Commercial
CBDG Funding
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PROPOSED IMPROVEMENT LOCATION:
Address: i1.o9 L-"Hr,'i=OAi-L-i-yAil: , J:d.L, P.Lk,- F Fz 3qr/&-
PropertyTaxlD#: igc,) i3b Late r�e,r
Site Plan Name: Li:czn,--L,-
Project Name: t &1sD" L-L- Ci-F W 1-1A&- i=6-AJcc`
DETAILED DESCRIPTION OF WORK:
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Residential
Lot No. iZ
Block No.��
cL 2 L.I e3r41 n4'41- �iFy4— VIA' Yt_ CIrillicf &Alk 1-;Laee-- iAj.,.,zi
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank — Gas Piping Shutters
Electric — Plumbing — Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 2. ,3 94, Dc-3
Generator
Sq. Ft. of First Floor:
Windows/Doors Pond
— Roof Pitch
Utilities: —sewer —Septic
OWNER/LESSEE:
CON
Name 54sL- LLzht�i
NamE
Address: p°fir LJH17-L c*K.L/YnLG
Comp
City: rr 1'rrl6Lf- State: _
AddrE
Zip Code: .a'' 9'&'L Fax:
City: -
Phone No. 7Z7 Bib jo-241 E-
Zip Cc
Mail: T7Z isii PAvL 12"""V'e C'--7,4
iL
P h o n c
E-Mai
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State
Building Height:
I KACTO R :
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any: A 6kti--w7 Y:kxtc1-:
ss: 3 1 Aita
Pc—r~ S: LI c State: FL.
de: 24 -PR4; Fax. -7 7 L 40B o272 2
No `332 &12_ 6Z2-3
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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
Name: Name.
Address: Address:
City: State: City:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
ZIP: Phone:
Not Applicable
State:
Not Applicable
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 post d on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an att" ne before commencingwork or recordingour Notice of Commencement.
Signature of Contra der s applicable
STATE OF FLOIeA
COUNTY OF (r S'r Lix1 t
Sworn to (or affirmed) and subscribed before me of X Physical Presence or Online Notarization
this 3 day of J,4,wL;xr:_-/ , 20Il—by
C���uncc t3i+L&ct
Name of person making statement.
Personally Known SL OR Produced Identification
Type ventification ProdAced
(Signatur Notary Public- State of A )
Commission No. �. /c� ea
�.l Notary Public State of rlorida
Crystal E Nay€on
y Niy Commission GG 929549
Expires 1110612023
REVIEWS
DATE
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
RECEIVED
-DATE
COMPLETED
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