Loading...
HomeMy WebLinkAboutBuilding permit application All APPLICABLE INFO MUST BE COMPLETED FOR-APPLICATION TO•BE ACCEPTED r` Date:" ����'�° � Permit Number: q no • 1 �: - Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)'462-1578 PERMIT APPLICATION FOR: j bt .a a iV1 Address: d G 09I0 10 Property Tax ID#: / y f7QZ Lot No. Site Plan Name: Block No. Project Name: O o �/C New electrical Meter Second Electrical Meter 4 ITIF M 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: Sq. Ft. of First Floor: Cost of Construction:$ r Utilities: —Sewer —Septic Building Height: �c;�:-�h.;�, z ->.r.�. ,;.� ��.� �. � - �,.;`•��a�—ra+^+�.y. vF"�`r���,�»�,"` �` .`✓ ,cx:, ,..:sr .,f•��'� ��T' ���€.�'�-�. ^�K �.e.Ya��.:�v:,,���-w' ,� Name O _!�- ©a Name: Address: / aF n Gf Company: City: Al ��rz'r?Ce State. / Address: Zip Code: 3Gl 9-1/ q 'Fax: City: State: Phone No. ?'i��16 6 .�/ Zip Code: Fax: E-Mail: eT(IofideR%�oo III Ilako com 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 ApplicablerName: AGE COMPANY: _Not Applicable Name: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:Applicationis 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 thepermit-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 improvementsto'your property. A-Notice of:Commencementmust_be recorded.in the public records of St.: Lucie County and po ed on the jobsite before the first inspection.-lf'you 'intend to obtain financing, consult ith lender or an arrorney before commencing work or recording our Notice of Commencement. nature of Owner/Lessee/C tractor as Agent for Owner Signature of Contractor/License Holder . STATE OF FLORIDA STATE OF FLORIDA COUNTY QF � ` �/`^� � COUNTY OF 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 f ,20 Jby this day of ,20_ by I 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 Nota u li - (Signature of Notary Public-State of Florida) ELLEN VAUGHN Commi i P e,° e of Florida-Notary (Sw4 Commission No. (Seal) Commission # GG 270079 My Commisslon Expires Amin _ REVIE FRONT ZONING SUPERVISOR PLANS' VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW LRev.!:)/ ED