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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Nui Building Permit Appli Planning and Development Services Building and Code Regulation Division Commercial 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERM ITAPPLICATION FOR: Swc r5 Address: L AUG 19 "?) Lucie County, Permitting Residential C? X Property Tax ID#:®/3d1 -61/ 0'X116 - 6007 Lot No. /O Site Plan Name: Block No. Project Name: C1HVRR1JMAh= SYWTI7Rs New electrical Meter Second Electrical Meter 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: V Cost of Construction: $ 9DO.00 Sq. Ft. of First Floor: Utilities: _Sewer _Septic Building Height: QW IER LES$E§ ry P t v My 43< Ai v "±t v^ �sv..,i. ter... 5,..... ....5 Gc ffi. ..A-Y'. T v l �fR] hY i M1j Y A{ Y N PL iiO " Name UTI ff i 113 , lP/�E Name: AddressSW5 4i ILDA hA10E Company: City: © FDRr Pima State¢FI- Zip Cod— �3495 Fax: Phone NV. i77.-0R0- Address: City: State:_ Zip Code: Fax: Phone No E-Mail: 0 C4,00KER9 6JI1A/L t6fil 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 reguirea. If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. r r MORTGAGE COMPANY: _ Not Applicable Name: DESIGNER/ENGINEER: _ Not Applicable Name: Address: Address: City: Zip: Phone State: City: State: Zip: ' Phone: FEE SIMPLE TITLEHOLDER: 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. ['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 Cgunty and posted on the jobsite before the first inspectiomIf you intend to obtain financing, consult ..;+k i Ae. knf„ro rnmmenrina wnrk nr:rPrnrdine-%)nur Notice -of Commencement. ' r ,TiB?a ` —oof,'own " -Lela a/Contractor as Agent for Owner Signature of Contractor/License Holder . STATE OF FLORIDA�1 , p STATE OF FLORIDA COUNTY OF. COUNTY OF Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of Ph y ical Presence or Online Notarization Physical Presence or_Online Notarization this day of 207U by this _ day of 20_ by Name of person making statement. Name of person making statement. f Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identificatigjr.� 1 Type of Identification Produced ii ICAIR Produced (Signature of Notary Public at of Flori a (Signature of Notary Public -State of Florida ), A ^ Commissio p "':''U'o ELLENi a NoFHN �blic Commission No. "e(Seal) `� Commission N GG 270079 - • ' omm[ssiori Expires oc Ober REVIEWS UirFi G SUPERVISOR PLANS VEGETATION SEA TURTLE MA(VGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW' REVIEW DATE RECEIVED DATE COMPLETED ev.