HomeMy WebLinkAboutmonument sign detailAll APPLICABLE INFO
T MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
.� I
Date: ? [ �-- Permit Number:
Building Permit Application
Planning and Development 5ervices' Residential
Building and Code Regulation Division Commercial _J_..._____-.
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 — T
PERMIT APPLICATION FOR: � , �°� I i ti F
PROPOSED IMPROVEMENT LOCATION.
Address: -- 4-
Property Tax ID #:
Site Plan Name:
1
Project Name:
DETAILED DESCRIPTION OF WORK:
9`I0 `-
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Lot No.
Block No.
Additional work to be performed under this permit— check all that apply:
_Mechanical — Gas Tank —Gas Piping Shutters -Windows/Doors ® Pond
_ Plumbing Sprinklers Generator ® Roof Pitch
Electric � g
Total Sq. Ft of Construction: fir/ Li Sq. Ft. of First Floor:
Cost of Construction: $ r— Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
Name PK `
Address:
City: State L
Zip Code: Fax:
Phone No.
E-Mail: `�� {n.2I rfl P . �M
Fill in fee simple Title Holder on next page ( if different
from the owner listed above)
CONTRACTOR:
Address:_X/a ��t/'AA• --e-
City:
A1 ` Stater
Zip Code: Ca �� Fax:
Phone No -X(�
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.
Name:
City:
Zip:;
Applicable MORTGAGE COMPANY: Not Applicable
Name:
Address: State: —
tate: City:
7 �-5;6 K Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: �iNot Applicable
Name:
Address:
City:
Zip: Phone:
ion is hereby made to obtain a permit to do the work and installation as indicated.
OWNER] CONTRACTOR AFFIDVIT: Applicat
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
inP ea e� consult wlth yeur Home OwnOers Association �andrreview your deed for any restrictions which restrict apply prohibit such
in consideration of the granting of this requested permit, 1 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
property: A Notice of Commencement must be recorded in the public records of St.
improvements to your
Lucie County and posted on the bsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney b r commencin work or recording your Notice C�omme�ce t-
r as sent for Owner
STATE OF ff.OWDA
COUNTY OF
worn to (or affirmed) and subscribed before me of
r Physical Presence or online Notarization
this 3b day of
Name of person making st ement.
Personally Known OR Produced identification
Type of Identification
LProduced
(Signature of Notary Public- St
R %
REVIEWS FRONT ZONIf�l� 6,1 " �SUPEgvl
COUNTER REVIEW",®�0
DATE
RECEIVED
DATE
COMPLETED
STATE OF PL�itfO
COUNTY OF�"a M2%_
S orn to (or affirmed) and subscribed before me of
TPhysical Presence or Online Notarization
this �C> day of 2020 by
Name of person makirig stateme
WP
Personally Known_ OR Produced Identification
Type of Identification
Produced
�rf
(Signature of Notary Public- State offlatiri`�
Y�
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PLANS VEGETATION SEATUIL "V
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