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HomeMy WebLinkAboutBuilding Permit Application SY All APPLICABLE INFO MUST BE.COMPI�A PLICATIOW TO BE ACCEPTED Date: Permit Number. •V � �O!/l��L(Je r Building Permit Application Planning and Development Services Building and Cade Regulation Division Commercial Residential 2300 Virginia .Avenue;Fort Pierce FL 34982 Phone:(772)462-1553 Fax: (772)462-1578 PERMIT APPLICATION FOR: I r Address:. I'Adr,I l� Property.Tax ID#: �y�� • J d�• �, Lot No. Site Plan Name: Blo&No. Project Name: .tom'Pis ✓. IL New electrical Meter Second ctrical Meter Elliman Additional work to be performed under this permit-check alf that apply: —Mechanical. ^Gas Tank —Gas Piping �Shutters _Windows/Doors `Pond. Electric _Plumbing Sprinklers Generator _Roof Pitch Total Sq. Ft of Construction: UZv Sq. Ft.of First Floor: Cost of Construction:$ •lities: _Sewer _Septic Building Height: Namea •.yL,�r�,� li Name: d . Address: :3400 t 11`x;;,, Company: City ��• fZr'oree- State:�L Address: o � �1 �j L Zip Code: T'ff S aZ Fax: City: state:,- r,/'�P Phone No. Zip Code: Fax: E-Mail: Phone No A Fill-in fee simple Title Holder on next page(if different E-Ma1l__-2)w11e_* r, 3' ��sC'-1C�A • b F'� from-the Owner listed above) State or County License G'6.4t411 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. DESIGNE ENGINEER: T Not Applicable MORTGAGE COMPANY:. Not Applicable. Name: Name' Address:_ Address: City: State: City: State~ Zip: Phone Zipr 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 worts or installation has commenced prior to the issuance:of a permit. St.Lucie County makes no representation that is.granting atpermit will authorize the permit holder to build the subject structure which is in conflict with any applicable Home Owners.A§sociation rules,bylaws or and covenants that may rkstricGor prohibit such Horne structure.Please consult with,your Hoe Owners Association add 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,-41`41 tespecti,p"rril,the work in accgrdance 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 roams and accessary uses to another non-residential use WARNING TO-OWNER:Your failure to Record a Notice pf 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,apd posted on,the jobsite,before the first inspection.if you intend to obtain financing,consult with lender of=an attorne •before commencing work or ret6rding yogr Notice of Commencement.. 11 01 Signature.of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder': ' STATE OF FLORIDA STATE OF FLORIDA COUNTY OF_, © �_ COUNTY OF Sw to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of h ical Pre ce or Online Notarization Physical Presence or. Online Notarization this=day of 20n-0 by 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 (Signature of Notary Public-State ofTlorida) -`ot"wY`�i%; . AUDREY S.HUMPHREY Commission'No:. (Seal) COMMIA#GG 300817 Commission Na. Po,? EXPIRES:March 8,2023 ,E•0.•gip REVIEWS FRONT ZONING.-'. .SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE. -COUNTER • REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW PATE RECEIVED DATE COMPLETED eW.