HomeMy WebLinkAboutbuidling permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:CZ��\ \CJS,Z�ZA Permit Number:
G' 5
" 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:
PROPOSED IMPROVEMENT LOCATION: '
Address: 1 �� �L �C��C` 1 G, �—�v� i SL iClP-� .-..- -
Property Tax ID #: �� ��' �J7 C5�'j - CX�U Lot No.
Site Plan Name, Block No.
Project Name:
DETAILED' DESCRIPTION OF WORK:
Q-
,CA-31-DI-
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 �ndows/Doors _ Pond
_Electric _Plumbing —Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $
Generator —Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNERAESSEE:
Name "�v
CONTRACTOR:
Name: r�
^
Address:kk h1� aC2C. �16. P-�
Company-W
City: PSL Stater_
Zip Code: ���� Fax:
Phone No.
Address: 2-(J (--0ru5 S4
City: (>0\- State:
Zip Code: -5-ACY&Lo Fax:
Phone No�i'1 Z• &'ii. 36t-)5
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail a.X rvcc-e & wr'd • GJ
State or ounty tense .33R2 s i
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.
"I
SUPPLEMENTAL 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 Applica
BONDING COMPANY: _Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: P e:
Zip: Phone:
OWN NTRACTOR 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 con, 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 inspectio ' tend to obtain financing, consult
with before c mmencing work or r i ur Notice mencement.
Signature of Owner/ Lessee/C ctor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLO�1jlRA`\
COUNTY OF `�G�
STATE OF FLOjj22ttDDyy11 1
COUNTY OF " 1 IC —Le
I
S rn to (or affirmed) and subscribed before me of
rn to (or affirmed) and subscribed before me of
+
_ ysical Presence or Online Notarization
this day ofYCcr`tyre�h.1 . 7A20 by
ysica ence or Online Notarization
this day �l�.1�C_r 2W216 by
Yfi
TZ t 4 n \-C�Qs �uTS 2�1
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lsttaattevvy
Name of person making statement.
Name of person making statement.
Personally Known�OR Produced Identification
Personally Kno 1 OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
�.
otary PUUIIC Slate of Amda
(Signature of NotaryT.Expims
Commission No.shley L�eJ It,
y COQ MMMon HH 052369
10/112024
(Signature of Notary bli $T a orJ a
tom �i. o ary Pybli • State o1 Fh,rta
Ashley Del ToQ
Commission No. - My Comm({ftliIiH 052369
am Expires f 0/11/2024
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FRONT
ZONING
SUPERVISOR
PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
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COMPLETED
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Rev. 5
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