HomeMy WebLinkAboutBuilding Permit Application -All APPLICABLE INFO MUST.,BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: i PerrrtitNumber:.
Building Permit Appli iation . AUG
Planning and'Development Services
t i^ t,�,i y o J n
BuildingandCode Regulation Division Commercial R-esidentiai r.
2300 Virginia Avenue,Port Pierce FL 349821° x'11
Phone: (772).462-2553 Fax: (772)462-3578 --
PERMITAPPLICATION FOR:
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Address: 5_1_ C_�
Property Tax ID#: . 3`Yad,9 C10 ya Y ? . .000 c3 Lot No.. 3
'Site Plan Name: -rat tBlock No. 8 7
Project Name:.
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New electrical Meter Second Electrical Meter
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Additional work to-be performed under this permit-check all that apply:
Mechanical Gas Tank _ Gas Piping _Shutters _Windows/Do'ors' _Pond
_Electric Plumbing —Sprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: 127 1. OF- Sq. Ft. of First Floor:
Cost of Construction:$ Utilities: —Sewer —Septic., Building Height:
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Name- 14 X —� c� Name:--
Address:
ame::Address: , �� �,. Company:
City:_� f�r���, State: Address:
Zip Code: Fax: Z;!? yg n -Z= City: State:
Phone No. ;?Z2 ,Z.Z y� Zip Code: Fax:
E-Mail: s G"13,�/_ r� A04, C-c- to 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.
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _ ot,App-cable..
Name: Name
Address: Address:
City: State: City: State:'i
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 AFF16VIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or instaiiation 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 yout deed for any restrictions which may apply.
In consideration of the granting of this requested permit,I do hereby agree that I Will,Jn all respects,performAhe 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 andaccessory uses'to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in paying twice for
improvements td your property.A-Notice of Commencement must be recorded.in the public records of_St._
LucieCounty and posted on the jobsite.before the first inspection.Ifyou intend to obtain financing, consult
with lenderor'an attorne before co` 6ncing work ior-,recording ypgr Notice of Commencement'.
natur er/Lessee/Contractor as Agent for Owner Signature of Contractor/License Halder .
STATE OF FLORIDA: . . STATE OF FLORIDA
COUNTY OF_ V t%1'.�,t COUNTY OF
Sworn o(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Prese a or Online Notarization Physical Presence or Online Notarization
this Jday of 20t7 by this day of 20_ by
Name of person making state ent. Name of person making statement.
Personally Known �OR Produced Identification Personally Known_. OR Produced Identification
Type of(dent' n Type of Identification
Produced Q�!"'_A e , Produced
% Q�Ov
(Signature of to Public-State of Florida
_ (Signature of Notary Public-State of Florida}
'o<"p�py AUpREYB, P REY—I
Commission Na. 2 �1
MM1SSt S% 300817. Commission No: (Seal)
...... EXPIRES:March 6,2023
REVIEWS FRONT ZONING SUPERVISOR PLANS' VEGETATIC)N SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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