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HomeMy WebLinkAboutTerry Jackson permit apppCC�p�ED FOR pQPLICATIONTD BE pCCT�D 4ermitlVUm�er. USS BE COM All APPLlGAE3A_ 1NF0 M pate: i lication J uilding Permit APB $ Planning and Development SerVices Commercial Residential Building and Code Regulation Division 2300 Virginia Avenue, Fort pierce 723 62 1578 Phone: (772) 462-1553 Fax:( ) PERMIT APPLICATION FOR' Address: - "` ' � _ � Lot No.--. — C) Property Tax ID #: Rlock No. Site Plan Name, Project Name: C New Electrical Meter Second Electrical Meter Additional work to be performed under this permit- check all that apply: _Mechanical _ Gas Tank —Gas Piping _ Shutters —Windows/Doors Pond Electric _Plumbing _Sprinklers Generator Roof��"Pitch Total Sq. Ft of Construction: ,� © Sq. Ft. of First Floor: Cost of Construction: $ i,[Y L Utilities: —Sewer —Septic Building Height: Name L Address: City: State_ rc Zip Code: Fax: Phone No. E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name:X Company:, City: -ICAO Zip Code: Fax: _ Phone No __11 E-Mails State or County License it value or construction is Z3UU 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. Name:� State'• � Address'. kNarne:=� p,,,lIcable SIMTITLE HOLDER. Not APplica GC COMPANY' MORTGA Name: date: Address: GitY'. Phone = livable zlp • Not ApP BON�AN`l: Name: Address: City: phone: Address: Zip: City: Phone: ermit to do the work and installation as indicated. Zip: iication is hereby made to obtain ermit. subject Structure NTRACTOR AFFIDVIT: App - build the sub] OWNER/ CO commenced prior to the issuance of a p permit holder toprohibit such a restrict or i certify that no work or insta4latian has Comm a ermit will authorize randpcovenants that may our deed for any restrictions which may apply. hcable Home Owners Association rules, by perform the work St. Lucie jaunty makes no rear our Home Owner Assoc atian and revi we that I Will, in all respects, which is tin conconsultwith any app ermit, I do hereby g gmei idments. structure. Please consult with y of this requested p Codes and St. Lucie County In consideration of the granting t from undergoing a full concurrency review: room additions, in accordance with the approved plans, the Florida Building Dins and accessory uses to another non-residential use The following building permit applications are exemp twice far cols, fences, walls, signs, screen rooms result in paying accessory structures, swimming pUblic records Of St. Consult ert A Notice of Comme � be recorded in the ntend to obtain financing, WARNING TO OWNER: Your failure to Record a Notice of Commence m improvements to your property. obsite before the firs p ` Lucie County and posted on the 1 �A,ifh larder or an attorne before commencin work or recordin our Notice of Comme Signature of Owner/ Lessee/Contractor as Agent for Owner STATE OF FLORIDA �. COUNTY OF Swo �o to (or affirmed) and subscribed before me of Phys I Prese e or Online Notarization this Y of - 2020 by 'TL t Rat-)VI �r Name of person m=OR nt, Personally Knownroduced Id Type of identification Produced (Signature of Not ry Public- State of Florida ] Commission No. 3_%eal] REVIEWS FRONT ZONING COUNTER REVIEW DATE RECEIVED DATE COMPLET �ys ,vV Signature of Contractor/License Holder STATE OF FLORIDA COUNTY OF Nlic)?swal (or affirmed) and subscribed before me of Pres a or Online Notarization this day of 2020 by Name of person making statement. i' Personally Known 1��®Rroduced Identi Type of identification �a.. Produced _ k (Signature of Notary Public- State of Florida ] A N. m c a��' Commission No. (Seal 9. n� � w (nn W N ta a n� c) OyL N N O y P Gs�i O N o ERS$lsb PLANS VEGETATION SEA TORTLE A11iGR@) Ti11�Q REVIEW REVIEW REVIEW RFVIFXAl