Loading...
HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ZGro Permit Number: 400 % — ©UO (a Or RECEIVED o , Building Permit ApplicationL �U� 0 8 2020 Planning and Development ServicescieC nty, Permit) Building and Code Regulation Division Commercial Resid 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: Address: 1167 1,4xi�n4)-4 QL-9 Property Tax ID #: 13e1-C11- 0117_00©- `S Site Plan Name: Project Name: IUXIZ STe)k,%E SNP New Electrical Meter Second Electrical Lot No. Block No. 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: /Z-V Sq. Ft. of First Floor: Cost of Construction: $ 02 3 ?5 Utilities: _Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name (31AP ► w.0 Name: Address: '71el L4 Company:' - - City: I occz State: FL Zip Code: 3 3 Fax: Phone No. Address: City: `, '-. State:_ Zip Code:- . , _ Fax:. " Phone No LV Y E-Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail 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. •o sr DESIGNER/ENGINEER: Name: o _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: Zip: Phone State: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: Name: Not Applicable BONDING COMPANY: _Not Applicable 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 Counter 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 your Notice of Commencement. Signatur of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDAL STATE OF FLORIDA COUNTY OF �) bh! /t COUNTY OF Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of Physical Pres nce or Online Notarization Physical Presence or Online Notarization this -� — day of )2020 by this _ day of 2020 by J601,/ MC'3r) Name 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 11otary Public -State of Florida) (Signature of Notary Public -State of Florida ) Commission ,, veaGN S. t16F21}SEN Commission No. (Seal) ""�Pb¢ ;Slate c Florida -Notary Public - = Commission H GG 207484 p oa¢ my "� ommissi 202 REVIEWS ISOR PLANS VEGETATION SEATURTLE MANGROVE REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. bIbILU