HomeMy WebLinkAboutBuilding Permit AplicationAll APPLICABLE INFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 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 Commercial Residential Yes/Ag
PERMIT TYPE :Electrical Pump Service for Ag Exempt Property
PROPOSED IMPROVEMENT LOCATION:
Hdr,t 8904 Carlton Road - K-vu...., �: I _ i�►A� i
Property Tax ID #: 3234-211-0001-000-3 Lot No.
Site Plan Name: Smith - Electrical pump service Block No.
Project Name: Electric and well for property
DETAILED DESCRIPTION OF WORK:
No Fee
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height:
OW N,ERAESSEE;
CONTRACTOR:
Name Wade & Michelle Smith
Name: Owner/builder
Address:2534 Madewood Drive
Company:
City: Fort Pierce State: _
Zip Code: 34981 Fax:
Phone No. 772-528-4524
Address:
City: State:
Zip Code: Fax:
Phone No
E-Mail: MLSWS95@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
State or County License
o — U«IuII ib ?c,uu ur mure, a KMUK1Jt1J rvonce or t,ommencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SRPi1`fA.QN 1€if:1`tFtl{ = ;'
DESIGNER/ENGINEER: xx Not Applicable
MORTGAG COMPANY: Not Applicable
Name: xxxxx
Name:
Address:
Address: "
City: State:
Zip: Phone
City: State: -P-(—
Zip: 341J�j Phone: a ---
FEE SIMPLE ITLE 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of O4Lesn ��r
Signature of Contractor/License Holder
TERES LOGOESTATE OF FL <`. notary Rublic - state o` F�or�da
, ; .COUNTY OFCommission 2 GG 19254y
STATE OF FLORIDA
COUNTY OF
w omm. RD-res - ay . 7nQ ± ;ouch A tionaI notary Assn.The f� ,rg oing in
this M day of 20 by
The forgoing instrument was acknowledged before me
this day of , 20_ by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Not Publ State of Florida)
(Signature of Notary Public- State of Florida )
fFl,y
Commission NoQ L*A L< '1 (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.