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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: z 2_© Permit Number: 91ro 1U9U[E v 11, O Q._.t . `°-n 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: S jFK J Address: Property Tax ID ; Site Plan Name: Project Name: New Electrical Meter ''." Second Electrical Meter Lot No.�_ Block No. Additional work to be performed under thi permit — check all t� apply: Mechanical _ GasTank _ Gas Piping _Shutters _ Windows/Doors — Pond A-flectric .-P�lumbing _ prinkiers _ Generator ff -doRoof Pitch Total Sq. Ft of Construction: Q, C? Sq. Ft. of First Floor: Cost of Construction: $ S�> �E Utilities: _Sewer !no_ eptic Building Height: a131 s y Name Address: I `t0) City:- I?�ir/p State: �L- Zip Code: �3y 57g A Fax: Phone No. �7,9" 302k -' sta q -7 E-M a i I : I, G o , to e,1 71 q Fill in fee simple Title Holder on next page (if different from the Owner listed above) Name: Company: Address: S�190 1',`-J-,r u S 7/%/e— City: -P:4-. (2irP rc9 State: F1 Zip Code: 3 LI 8 Fax: Phone No E-Mail��('`/n� State or County Licens 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. NONE" LAC® ��RJCTI®�E'N �� W IIN; O .I : `O' `�• � � � Ft 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 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 resulfln 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 attorneybefore tam mencin work or recordingour Notice of Commencement. ev. DESIGNER/ENGINEER:Not Applicable MORTGAGE COMPANY: Applicable Name: �L � S�� 3���� Thy Name: Address: Address: City: State: City: State: Zip: Phone�72�— � S� � Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _ of Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: sign atu-re of ner/ Lessee/Co Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OFF � )�11I�C .P✓n COUNTY OF Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization 2020 �by Physical Presence or Online Notarization this day of , 2020 by this ay of Name of person making ement. ' Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identifi 'on Type of Identification Produced � Produced � �\\IIIII„/ � `�SPRYP / C�L� n=