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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO. MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ' Date: AID), al Permit Number: > " �� �^+� �• 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: Address: 1 f 0f) W- M I d wu`/ r'C( Property Tax ID #: 3 TO q — so I ` 022 �- — 00 0 / Lot No. Site Plan Name: Project Name: (Z G I S P WcA #way �f WO ' -A cCo rc((' o^v(,- r P- /P ,, S�- New Electrical Meter Second Electrical Meter e '000XS Block No. Additional work to be performed under�this permit - check all that apply: _Mechanical _ Gas Tank Gas Piping, . _ Shutters _ Windows%Doors.<...f _ Pond" Electric Plumbing Sprinkl`efrs _ Generator Roof Pitch Total Sq... Ft of Construction: Cost of Construction, $ Sq. Ft. of First Floor: Utilities: —Sewer _Septic Building Height: t�UtilN'Ef��/L��SE -; C��NTR TOR.. Name i%1)CW Y �fF S Name: 6T©S� Address: (©'j 1i iul tea`{ rC Company: YA 0n FencrS (biro City: S L C-( fc CUy Zip Code: Fax: Phone No. State: L Address: P2fo 10 01 C00 -P Op BOG City: LPCS4' (hl fA Zip Code: 3 3 Phone No 30-S E-Mail ffCA �QW (b(-4 + Fax: -'®°lI C4C `S IOU State: FL - -kQi 9 Lf.Ci E-Mail: Fill in fee simple Title Holder on next page from the Owner listed above) ( if different State or County License t✓ i 52 �� Z® 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. MORTGAGE COMPANY: _ Not Applicable Name: Address: DESIGNER/ENGIN..ER: _ Not Applicable Name: 2lckafG fk' I F_MISoN Address: e. o, .a o S fo City:. P Pc C- State: f-L City: State: Zip: 3 Tcii Stj Phone. 7 2 2l S S f 2 3 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 ppermit 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 Cinty�nd posted on the jobsite before the first inspection. If you intend to obtain financing, consult with len riot an attornev before commencing work or recWing vo' ur Notice of Commencement. 3L Signature. of Own r/ Lessee/Contractor as Agent for Owner Signature of ntractor/License Holder STATE OF FLORIDA STATE OF FL RIDA 4,��j COUNTY OF COUNTY OF4 Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization liysical Prese ce or Online Notarization this � day of 20�(%by this day of tp 20,Z�Vby bS� wn��ose Name of person making statement. Name of person making statement. Personally Know OR Produced Identification Personally Know OR Produced Identification Type of ]dent' icatio • Type of Identifi on. _ tiJ _ 1 Produced C. Produced ` • (Si ature o NotJ4 Public- State of Florida (Signature of Not Public- State of lo'rida Commission No.di AUDREY B. WAREY Commiss' (Seal) *? *: MY COMMISSION # GG 300817 t %Py -,, =o.• �i�; AUDREYB.HUMPHREY %FgFF°P Bond ThruNotary Pulilic. ndei;;riters - ;o � GG300817 REVIEWS ISOR PLANS T�TI',� E MANGROVE ry ' 'COUNTER REVIEW REVIEW REVIEW riters REVIEW DATE RECEIVED DATE, COMPLETED Rev. 5/6/20