HomeMy WebLinkAboutBuilding permit ApplicationAll APPLICABLE INFO MUST L
0IMPLETEDtFORAPPLICATION TO -BE ACCEPTED
Date:
Permit. Number: '
Building -Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia A venue, Fort pierce FL 34,982 Commercial Residen'tial
Phone: (772) 462-I5.53 Fax: (772)'462-1578
PERMIT APPLICATION FOR:
Address :-:I a" ��Lcl
Property Tax ID #:
Site Plan Name:
Project Name:
10
-V5ak--3-Q 'F
Cyr ck-
Newelectrical Meter-- Second Electrical, Meter
Additional work to be performed under this permit- check all that apply.
—Mechanical Gas Tank — Gas Piping Shutters
Electric Windows/Doot'
Plumbing — Sprinklers Generator
Total Sri Ft-; Construction:
Roof
Cost Of Construct16; ISq. Ft. of First Floor:
Utilities: —Sewer _Septic
Nam
Name:
Addre 51
At tLtR 2
City:
r4 Y,- p Company -
Zip Code: State�r-- la Address:
Fax:
Phone No city:
-----------
E-Mail: Zip/ Code:
Phone No
Fill in fee simple Title Holder on next page if different E-Mail
J
frlm-the Owner listed above)
State or County License
a s 00
value of construction r m
r value Of is 2500 or more .1 value
a RECORDED Notice of Commencement is required.
,F W w
value Of HAVC is $7,500 or more, a RECORDED Notice Of Commencement is required.
Lot No.—d--
Block No. Lb
Building Height:
Pond
Pitch
Zip: Phone:
OWNER/ CONTRPICTOR A FFIDVIT: Application is herebymade to obtain a,pertmit to do the work and insEallation as Indicated.
f certify tllat,go work or'"installation has commenced prior to emTn noit w II ,authorize he hermit holdeii�tcfhaa may restricut or prohibit such
St Lucie'County maKes!no tnN���. ••�
which is in conflict with any applicable Home Owners is -
structure: Please consult with your Home Owners Association and review your deed : or an perform the work .
n consideration of the granting of, thilan .s requested permit, I do,hereby agree that I will, in all respects,
l roved this, the"Florida Building Codes and St. Lucie County Amendments.
in• accordance with the approved
The following building permit applicaxtons are exempt from undergoing a full concurrry uses -to a room additions,
ctures swi'rnming pools, fences; walls, signs, screen rooms and accessory uses -to anothe a in f etwice foruse
accessory stru . may, result in p ,Y g
o e' A Notice of Cornmencernent mus I be recorded rt the Public records of St.,:
- ur r rty ion. ou intend to•obta 6 finan_cing; consult
WARNING TO OWNER: Your failure -to Record a Notice, of Commencemen
improvements to, yo p . I?, . ,.
Lucie County and,'posted •on the` jobsite before-thefiest-Inspect y
..,. i tAnrler or an attorne before commencin work or recordin our Notice of Commencement.
re of Owner/ Lesse
as Agen0or owner
STATE OF FLORIDA
worn to (or affirmed) and subscribed before me of
e Notarization
Physical Presence or online Notarization by
this V_d'ayof
C
Name of person making statemen .
Personally Known
OR Produced Identification '—
—
Type of Identification
i .n ture of Notary Publi State of Florida f2AHMWG
(, .g
LASHAHN iNGRAM�
.tis�.eU°�� , #.GG 275060
Commission No. iY GoiJi^AI
EXPIRES: December20, 2022
SUPERVISOR
REVIEWS FRONT ZONING REVIEW
r ni rniTFR REVIEW —
IIDATE
RECEIVED
COMP
Signature of Contractor/License Holder .
STATE OF FLORIDA
COUNTY'OE
Sworn to (or affirmed) and subscribe online Noed re me ton
(Physical Presence or — , 20_ by
this day'of
Name of person making statement.
Personally Known —OR Produced Identification - —
Type of Identification.
Produced
(Signature of Notary.Public- State of Florida)
(Seal)
commission No.
PLANS' VEGETATION ' S EA REVI�EVVLE-REVIEW
REVIEW REVIEW