Loading...
HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ® � 9-z Permit Number: C) , i o n F � -= Building Permit Applicationj i Planning and Development Services2020 f + Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue,Fort Pierce FL 34982 Phone:(772)462-1553 Fax: (772)462-1578 PERMIT APPLICATION FOR. Address: -Z2 o n �`�/4-iti/� A(1i(t.,�\ {�bti� I�G�iZGG �1. �� C/ r/ Property Tax ID#: l-� D �Q l� lam ) _ Lot No. Site Plan Name: Block No. Project Name: I D D ' GRIP • OF OR (10c)c4 d�2V ��� o��e �,a�e/z 0'r 6fe,� ctif l� ve w e� rz� �f,g ld . Wfe-y "e 1�s �- A 1 -*C/( ,ver,- /e New Electrical Meter Second Electrical Meter CONSTRUCT ON INFORMAT ON: 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 o-�Roof On/ Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ o� �e(2O Utilities: —Sewer _Septic Building Height: OWNERf LE3•S��E CONTRACTOR: Name/Uo/Ll7�ii7�° /4. -/v f,7,o=r Pow"- Name: - Address: -75 o-11- Company: City: State: LCzl Address: Zip Code: Fax: City State: Phone No.9-?-2- l3 - kd -9-6 Zip Code: Fax: E-Mail:4 zA_,b ZC.t�t�'/ /,ter f�`G , c c 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 required. If value of HAVC is$.7,500 or more,a RECORDED Notice of Commencement is required. SU ' PLE E AL C•QNSTRUCTIO LIEN LAW I F©R AT aN' 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 paying twice for improvements to your property. A Notice of Commencement must be recorded in the public records of St. Lucie County 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. V S V nature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA )) STATE OF FLORIDA COUNTY OF �'�' �/G�e COUNTY OF Swore to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of ✓Physical Pres a or Online Notarization Physical Presence or Online Notarization this__34 day of 2020 by this day of 2020 by aws Name of person making statement. Name of person making statement. Personally Known OR Produced Identification '� PersonallyKnown OR Produced Identification Type of Identificayt'' n Type of Identification Produced air • 1 G Produced (Signature of NotAk Public-State of Florida) (Signature of Notary Public State of Florida) �Pp'"�'''• AUDR ((UMPHREY :o••...•s��3 Commission No. My #GG 300817 Commission No. (Seal) *c EXPIRES:March 6,2023 0 3ry r 010 Undenwiter,� REVIEWS FRONT ZONING SPLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.