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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPI1 ,_`,) FOR APPLICATION TO BE ACCEPTED Date: Permit Number:;2no " VJ < Building Permit Application 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 PERMIT APPLICATION FOR: Address Property Tax ID #: Site Plan Name: Project Name: _ 6 New Electrical Meter Second Electrical Meter CONSTft+1.! dN .IN`F0.4100110, a" f Additional work to be performed under this permit -check all that apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors . IElectric - _ Plumbing _ Sprinklers _ Generator _ Roof Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ b D ©�— Utilities: —Sewer —Septic Residential V el Lot No._ Block No. Building Height: Pond Pitch Name �1'� �iN a�c�a 10 r�' Name �r_� .,06 n re `Address: -7-31S ��yT IG 18(_)ec� 91.1.4 Company: ('� vace E-Lee fr(c_ LLC T City: ct�� �1 �i�'svr✓ l S'LA State: p Zip Code: Fax: Phone,No.0!�L - 29?!y Address: 1 61 Pr_ City: V� Zip Code: Phone" No, y �r7 Stater Fax:-2 72 - s69-o�w� - 1)al E-Mail:. -Fill in fe6)simple Title Holder on next page ( if different from the Owner listed above) E-Mail State 01' Cdunty License E C j�� 06G (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. 4 DESIGNER/ENGINEER: _ Not Applicable Name: Address: City: State: Zip: Phone MORTGAGE COMPANY:. Name: Address: City: Zip: _ Not Applicable State: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: BONDING COMPANY: Name: Address:- City: Zip: Not Applicable Zip: Phone: " Phone: I OWNER/'CONTRACTOR AFFIDVIT: Application is hereby made to obtain a per it to do the work and installation as indicated. I certify that no work or installation has commenced prior to the issuance ofa 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 andlIcovenants that may restrict or prohibit such structure. Please consult with your Home Owners Association and review your deed fbr any restrictions which may.apply. In consideration of the granting of this requested permit, I do hereby agree that 1 will, in all respects, perform the work in accordance with the approved plans, the Florida Building Codes and St. Lucie Count 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 County and posted on the jobsite before the first inspection.. if you intend to obtain financing, consult with lender or an attornev before commencing work or recording vour Notice of Commencement. . � tg' Signa of Owner/ Lessee/Contractor as Agent for Owner Signatu of Contractor License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF n,-2 COUNTY OF f JQ4� Sworn to (or affirmed) and subscribed before me of Swor (or affirmed)"and subscribed before me of �hysical Presence or Online Notarization Lf Physical Presence or Online Notarization this ;Z4 day of 20!0) by this Z�Jday of l ; 20:Z�1)1 by I Name of person making statement. Name of person making statement. V Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identifwqtion v Type of Identifica i n Produced Produced �� 99c� I �O `��II .` a$ Noi (Signature of:Notary Public- rate of Florida (Signature of Notary Public- t to of Florida) s n Commission No. (Se 3 m Commission No. (Seal) mn3o� �o�'- 3�r REVI.EWS FRONT 30oT ZONING R PLANS VEGETATION SEA TURTLE o-oN. ^- MA COUNTER REVIEW REVIEW REVIEW REVIEW d RErr DATE Na co< -n l N o C RECEIVED N, N °� aX ,"� DATE N� 0 COMPLETED y V 0 Q