HomeMy WebLinkAboutPermit Application0001AIIAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:Permit Number:
Building Permit Application
Planning and Development Services
Buitding and Cade Regulotion Division CommefCial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772)462^1578
Residenti "l X
PERM IT APPLICATION FOR:
PROPOSED I M PROVEM ENT LOCATION:I
Address: l<?,b ilv 7v+tat 8.Usfi etkue
propertyTaxlD*'/fZl--gt;-aSg-aaa-Z totNo.B
siteplanName: H4R.BI,t Ptf,-e, PuaT Bn &rt*ort|-hstoctNo.
Project Name:
" h?f ?12 gP HpHe oFF:cE I STuoto
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit - check all that apply:
Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Generator
X winoo*s/Doors_ Pond
Pitch_ Electric _ Plurnbing _ Sprinklers ,K noor
Total Sq. Ft of Construction: 213 Sq.Ft. of First Floor: bS l
Cost of Constructio "t S 15, OF Utilities: - Sewer - Septic Building Height:
lf value of constructiori is 2500 or more, a RECORDED Notice of Commencement is required.
lf value of HAVC is 57,500 or more, a RECORDED Notice of Commenc€ment is required.
CONSTRUCTI ON I NFORMATION:I
Name A|-FPED Fr. V€.4 llL Name: - l?YzD llhUtW- t
Address: /S4o ^t h/ AvTfoil Aust| ctg,company: B^Ltbout aopft*dt&-_ &1
ciq: PA|A ctT-(
'
Zip Code:Fax:
Phone No.
E-Maifl
Fill in fee simple Title Holder on next page { if different
from the Owner listed above)
Address:? |^t. ?rvtL RO .
City:State: F7.t
Zip Code:
Phone Nr-7<f , tZS, atlb
E-Mait low 6 Uvfo&T -c*JTIulLfNb,aovl
State or County License
r-
_ Not Applicable MORTGAGE COMPANY: XNot Applicable
BONDING COMPANY:ot ApplicableFEE SIMPTE TITLE HOLDER:
Name:
Not Applicable
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 Countv makes no representation that is grantine a permit will authorize the permit holder to build the subject structure
wniih is in conflict with anv a'pplicable Home Owfrers AsSociation rules, bvlaws or and covenahts that mav restrict or prohibit such
itructuie. Please consult wjth your Home Owners ,Association and review'your deed for any restrictions Which may apply.
ln 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
Personally Known OR Produced ldentification
tr(lf olM
Swoqreto (or affirmed) and subscribed before me of
\./ Phvsical Presence or Online Notarization
tnTa'fidrv or Wu- ,2020 by
as Agent for Owner
STATE OF FTORIDAcitunrY dr-"'-'b,b- t-r1 ot€-
Sworn to (or affirmed) and subscribed before me of
V- physical Presence or - Online Notarilp*
this 5 day of TPre\"\r.P{i ,2020
Name of person making statement.
Personally Known l0 oR Produced lden
Type of ldentification
(Signature
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My Comm. Expires sep 19, ?021
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