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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE.COMPLETED FOR APPLICATION TO BE ACCEPTED _ Date: I Permit Number:� '©�`�`s 3N - Building pp Permit A lication Planning and Development Services Building and Code Regulation Division Co m rim e rci a I R esidential V 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)4.62-1553 Fax: (772)462-1578 PERMIT APPLICATION FOR. >. - Address: y� {{ Property Tax ID#: Ca�7�-�� . Lot No. Site Plan Name: Block No. Project Name: pF-x' `i�L'3Dx.�'a a.a a .tea`:'-. i 'MI. ' -�' "� ,�3 �'�z n'"a ��.�3�� ` ' � ` 'fi ''� ^�� GO C►2L 5�.NZ n Sid' O��lfl e, usa As M I @ Iii(t) (Sir A C'S'N 06D ins l New electrical Meter Second Electrical Meter �- {z-..:w..�, -'a�w`s�`=':,�.aa�` w 4. „^ �d 'x wur..t�,.r ,�:c?7krr� i�[_ "� � � � .�>" +-w' .} �x.*t,.� fy �'rT�f t� 4 I� �'nY. 'L^� r..t+"�. 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: i1I�0 SF 5q. Ft. of First Floor: Cost of Construction:$ (��I) = Utilities: —Sewer _Septic Building Height: ^y 'M„�er---—b ^'• �,x-*t .u'' YYLE � Eyn`�' Name '1 5� S Name: Address: ; 1'7 1J �W Company- City: T �e['(M, p (�t-w 0 State:11- Address:. Zip Code: 3AI Qq Fax: City: State: Phone No c- ' T b Zip Code: Fax: E-Mail: 71ADMASP L QC Phone No Fill in fee simple-Title Holder on next page (if different E-Mail from the Owner listed above) 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. 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: Not.Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/CONTRACTOR AFF16VIT: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 rip representation that is.granting a permit will authorize the permit holderto 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 consultwith•your Home Owners Association and review yout 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 poolsi fences,walls,signs;screen rooms and.accessory uses to another non-residential use WARNING TO OWNER:Your fa ure to Record a Notice of Commencement may resul't.in.paying twice.for improvement- to your pro erty.A-Notice of Commencement must be recorded'in the public recorcls of St._ Lucie'County d ted o the jobsite.before the first inspection.If you intend to obtain financing, consult ,wit rider o a atto ne efore commencer work or recording our Notice of Commencement- Signature' f Owner/Lessee/Cont ctor as Agent for Owner Signature of Contractor/license Holder . STATE OF FLORIDA . STATE OF FLORIDA COUNTY OF L_Lc rkl — COUNTY OF Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of Ph sical Presence or Online Notarization. , Physical Presence or Online Notarization i this day of Cc 20 by this day of 20_ by J �n.01m :tb(W rx� Name of person making statemen /. Name of person making statement. Personally Known OR Produced Identification— Personally Known OR Produced Identification .Type of Identificat- Type of Identification Produced < Produced (Signature of Notary Public St a of Florida). (Signature of Notary Public-State of Florida) Commission No. ELL AUGHN Commission No. (Seal) O�Y P4�� - ;a state-of.Florida-Notary Public =: += 79 e M Commission Expires 0 FtO� y REVIEWS FR -ZONIAElo,be,2 PLANS VEGETATION -SEATURTLE MANGROVE CO N E RE 71 E R V REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.5/6/20