Loading...
HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: Q- Building Permit:Application Planning and Development Services Building and Code Regulation Division Con1m&cial Residential� 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772)462-1578 PERMIT APPLICATION FOR: P'RCg}POSED IMPRO20 NT LOCAI'llON: ff - V(_fib l e tau Address: � b � Property Tax ID#: 33 ZZ g(� 66 S -6 60 =�2 Lot No. Site Plan Name: Block No. Project Name: �NeA es- D�TAILEi9 ©E�SCRIPTION OF WORK. New Electrical Meter Second Electrical Meter CON�STRUCT1fJN (N FOR RIM AT(ON� Additional work to be performed under this permit—check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Pond Electric X Plumbing' _Sprinklers, ' Generator Roof Pitch ' Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ k.�-1.5,o Utilities: —Sewer _Septic Building Height: 0�LE-sSE. � '� NTRAGTOR: Name Address: =� �i+ !� r`1 Company: �aC p�L� City: State: Address:-, AI w_ Gard It Zip Code: Fax City: Pe �T 1-[A(� "Pi State: ��- Phone No.� � ,::.'�2 Zip Code: 3W4$L"�'. pt:.Fax E-Mail: Phone.No Fill in fee simple Title Holder on'next page(if different E-Mail:ll hh 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. SUPPLE ENTAL C«ONSTRUCTI9,N LfEN LAW I'NF©RMAT14 N` DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: 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 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 per it applications are exempt from undergoing a full concurrency review:room additions, accessory structures,swi ming pools,fences,walls,signs,screen rooms and accessory use another non-residential use WARNING TO W R: Your failure to Record a Notice of Commencement y esult in paying twice for improve nt to your property. A Notice of Commencement must a ezm the public records of St. Lucie C ty d posted on the jobsite before the first inspection. u i obtain financing, consult with le er a t me b fore commencin work or recordin u c of Comme ent. . Signatu�' o Owner/Lessee/Contractor as Agent for Owner Signature Contractor/License Holder STAT OF FLORIDA STAT OF FLORIDA COUNTY OF S-y c: COUNTY OF 6 Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of Physical Presence or Online Notarization Physical Presence or Online Notarization this\L day of 12020 by this \\ day of '�SvJq 2020 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 L- L Produced Ft. 1p L-- (Signature of Notary Public-State of Florida) (Signature of Notary ublic-State of Florida ) Commissior�n �"-'-ems. � ( eal Commission No.( G,G (Seal) NA vi EXPIR S:December 16.:: REVIEWS;' »? �P�cdedThupdF�� ,UPERVIS0R PLANS V E G ET TId S16 tTLC MANGROVE J 0 u6dia.r:, EVIEW. REVIEW REVIEW23' tW REVIEW DATE RECEIVED DATE COMPLETED ev.