HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit N Imber:i.
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Building Permit Application 1
Planning and Development Services j
Building and Code Regulation Division
:2360 Virginia Avenue, Fort Pierce FL 34982 i
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
.PERMIT APPLICATION FOR:
PRQPOSED INPROV:EMENT LOCATION
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Address
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Legal Description: ��� ( OX 15 r� '� 01-A
Property Tax ID#: NO Do, .13`YOc o �" Lot No.
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Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side,:
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QETAILEQ Q�SCRIPT'ION OF WORK h` kfSFw ` ��`
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Unit 2898 Harson way will require the owner to pull a permit to fix electrical work that is a current code violation. Four
(4) wall receptacles, and at least two (2) of the ceiling fixtures, in the living room, on the 211 floor of unit 2898 do not r
have a circuit breaker within the units panel box. Ext. balcony light has the same issues. Water pump
addressed to remove non-compliant wiring also must be
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Rl7CTION Iiona work to e per orme under this permit–c ec a that appy: I
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_Mechanical ' —Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor. I
Cost of Construction: $ �7 ��� ��� Utilities: _Sewer _SI ptic I Building Height:
011NERJLESSEE CONTRACTOR:
,Name y NaAr e: a
:Address:fes' V t 1�/9 d1%�G / Company:
-City: 0411-1 Sr z"Clel State:" Address:
Zip Code: Fax: City: State:
Phone No. �7`l. f0 � � Zip Code: ,? I i' 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 regi fired.
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` I 'AE:, I�}STRUCTIONIILIN LAW INfORMAT[ON
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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:
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 and covenants that 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 your paying twice for.
improvements to your property. A Notice of Commencement must be recorded 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 our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent fo Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF L� `
The forgoing instrument was acknowledged-,�efore me The forgoing instrument was acknowledged "fore me
this ay of gcAr�) 20Jy by this ZS-day ofy
(Name o rson acknowledging) (Name of person acknowledging)
(Sig ure of Notary Public-State of rlorida) (Signature of Notary Public-State of Florida)
Personally KnownProduced Identification Personally Kn ed Identification
Type of Identifi atica., Type of(dent fill SOPHIA HARRIS
;; SOPHIA HARRIS Produced •'
Produced _ G; ° -'!7093
N#FF. 7093
°'?;orrL;,•` EXPIRES May 30 0020
Commission No � ""� EXPIRES Mjys��l)2020 Commission �U)398-0153 NotarySemcea )
ridallotary erwce.com
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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