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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE.INFO MUST'BE%MPLETED FOR APPLICATION TO -BE ACCEPTED Date: Permit_ Number Building P rmit Application Planning and Developmem .3L- /ces 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: „�a� 1V1cLc1 second Electrical: Meter Residential fi— 3A�i �-Z Lot No. Block No. Additional work to be performed under this permit— check all that apply: .,S'j/qtfAAd-� _Mechanical _ G'as '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 $ ; ;'e�(�— �y C Utilities: _Sewer _$eptic. Building Height: NameD( n InI^sVI.hq#2 T_ ff Address: ' GJo (n JIVLt,1,, d , City: State: _ Zip Code: '2,' Fax: Phone No. E-Mail: f►�+1� a Cc-yv, Fill in fee si�D-r�fw,,,lder on next page ( if -different from -the Owner listed above) Name: Company: Address:`3ZA3 SW "-iCAC, S �- City: P!/IL State: �- Zip Code: 346153 Fax: Phone No 77J, —a &+— E-Mail 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. Not App Name: ' Address: State: City: Pe Zip: hon FEE SIMPLE TITLE HOLDER: NOT J'►P,Pi1udU1U . ;i Name: Address: City: Zip: Phone: MORTGAGE COMPANY: Not Applicable Name: ' k Address: State City: Zip: 1 Phone, Not A plicable BONDING COMPANY: p Name: Address: City: Zip: _ Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a pe f certify that no;work or'inslallatioi.ri has.eommenced prior.to the issuance of a perm St. Lucie County makes no representation that is granting'a permit will ator a which is in conflict with. any, applicable Home Owners As rules,.bylaws structure. Please consult with1our Home Owners'Association and review your deec In consideration with the granting f this lansrthe Floridequested a .gu Iding Codes and St Luce Cot it, I do hereby agree that I �% in accordance with the approvedp. The following building permit applications are exempt from undergoing a full conci accessory`structures, swimming pools, fences, -walls, signs,,screen.rooms.and acces NER: Your failure�to Record a Notice.of Commenceme WARNING TO OW Irnpovements to'your-pcope;rty: A Notice,.of Commencement rn� Lucre Count ed on the jobsite-before ttfe first,inspectior with Gder an attorne efore commencing work or recordin as Agent for Owner Signature nit to do the work and installation as indicated. 3eem.it holder to'build the subject structure I any restrictions which may appl habit such. , in all respects,: perform thel work ty Amendments: :ency review: room additions, iry uses to anotherfnon-residential.use t may resultm paying;twlce.for t tie recoided in`the,publlc records of'St:.. If yow: intend to obtain finericing; consult dour Notice of Commencement. - Holder . STATE OF FLORItuA STATE OF FLORIDA LI 000NTY-;OF.L COUNTY":OF ��IAa Sworn Sworn to (or affirmed) and ubscribed before me of n to (or affirmed) and subscribed before me of Physical Presence or Online Notarization Physical Pres nce or Oniine Notarization , 20_ by' 20A by r this day of this d"ay of +� Name of person making statement. Name of person making statement. OR Produced Identification. OR Produced Identificationy Personally Personally Known — Type of Ide Type of Identification Produced_ Produced Sig ature of Notary Pu ic-'State of Flori ) . (Signature of NotaryPublic—State of Florida) HM{NG (Seal) 1 Ahi.Rp Commission �No. Commission No. ,1 ; �� •; �__ MY COMMISSI N i# GG 275060 EXPIRES: Decembec20, 2022 Fo'FF;° Bonded Thru o REVIEWS FR i` ' ING SUPERVISOR PLANS VEGETATION ' SERA VEWLE MRVII WVE COUNTER REVIEW REVIEVN REVIEW REVIEW 0 11 LKCEIVED