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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO'MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �30-a� Permit Number: P0070750 s Building.Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential V001- 2300 Ifirginla Avenue,Fort Pierce FL 34982 Phone:(772)462-1553 Fax:(772)462-1578 PERMIT APPLICATION FOR: PROPOSED IMP.ROVEM.ENT LOCATION: v Address: Property Tax ID`#: Lot No. Site Plan Name: Block No. Project Name: DETAILED_.DESCRIPTIONDF WORK: KNM \N New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: Additignal 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:$ ©o Utilities: —Sewer —Septic Building Height: OWNER,LESSEE: CONTRACTOR: Name Name: r Address: N EVA. Company: kS City: CQ -State: Addr s: vl�) h Zip Code:'?�W(51 Fax: City: � State•. C..- Phone No., Irl W1 •5-16r l Zip Code��X 3 Fax: E-Mail: ICI�VT Phone No q`l) * ' A Fill in fee simple Title Holder on next page(if different E-Mail V\4S 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. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: i 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 Count 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,wails,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. Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF— Lk ,�.v COUNTY OF Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of Physical Pre nce or Online Notarization Physical Presence or Online Notarization this_at_day of 20 A)by this 6 day of QLum 20L%AD by Name of pers n making atement. Name of perso making statement. Personally Known OR Produced Identification Personally Known OR Produced Identificationll Type of identification Type of Identification Produced Produced (Signature of NotaryRub't iSig11a« - -_ Florida ) v ! LASHAHNAINGRAM RAMMING Commission No. _� L� (= �� LASF1Ai��iG '` `: MY CQM(11 NION#GG 275060 Commission No. _4- - ra MING v o` EXPIRES:December20,2022 SX. ?ir1r14198f0� 75060 Bonded Public Underwriters '•prFOFr4oP EXP,i,,IS:December20,2022 r ¢; '_� Iderwiters REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE TXftOVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.