Loading...
HomeMy WebLinkAboutBuilding Permit Applicatioin All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 0 Date. Permit Number: goo we 0 • Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue,Fort Pierce Ft 34982 Phone:(772) 4624553 Fax:(772)462-1578 PERMIT APPLICATION FOR: �1ech0.n IQ f PROPOSED 1 PROVIMENT LOCATION: Address: I Q 7 Z , QCenNtJ t 3-3 ,!r q• II �^-0 [ B ©© Lot No. z [ S ! Property Tax ID#: SOI".J Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION OF WORK: h L` L' k New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: 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:$ `T .(30e- Utilities: —Sewer —Septic Building Height: OWNER/LESSEE: CONTRACTOR: I Name NAA)N Name: �i Address: ,c,%'r 0 Company: 2 S+G'S City:_13L00Ak r,eLA State:Ky Address: 1 I Zip Code: Fax: City:— Pn`+ 5+ L.A,%_C;e - State: r l Phone No. '�=�t�� �` - Zip Code: Fax: 335 -33 1 U E-Mail: Phone No Jq5• �1-3449 Fill in fee simple Title Holder on next page(if different E-Mail 2,�a-�e r !'�� G� �o� •Ga from the Owner listed above) State or County License C OL 15 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. SUPPLEMI ATAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: XNot 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. certify that no work or installation has commenced prior to the issuance of a permit. St. LucielCounty 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 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 County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording our Notice of Commencement. Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA ' ` STATE OF FLORIDA ( � COUNTY OF 2, Uap-JR , __ COUNTY OF Swo,Pfto(or affirmed)and subscribed before me of Sword°(or affirmed)and subscribed before me of Physical Presence @r Online Notarization Physical Presence or, Online Notarization this k, day of 2020 by this day of 2020 by Q Name of person ma��OR tement. Name of person making atement. Personally Known Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Flo Commission No. �Fd. Commissi �cate �O ( al) `a S a itckiieGG�� 3s �sr Notary Public State R slon 57 + My Commi on GG 135736 X 'fires 12f1 REVIE +� o�"dR1N5 1�1NING JUPERVISOR PLAN VET E7RTLE MANGROVE REVIEW REVIE REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.5/6/20