HomeMy WebLinkAboutbuilding permitA\\ APPUCABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCE~TED . • l l I'"\ l'\I)! Permit Number. _______ _
Date: I . (o \ JJ.J ±:1
ST. LUCIE -' COUNTY
FLORIDA~ Building Permit Application
Planning and Development Services Commercial ____ _ Residential -.J.----
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: L/;;).06 Sunrise,, t:,\\fd , Fact p;uce J P:'-3yq~a
Property Tax ID#: @ Y ?> :> -g O \ ' 0 0 0 I -Q O D -d--Lot No. L 2,? 1 I \
Block No. -'-I __ Site Plan Name: _________________________ _
Project Name: _________________________________ _
I DETAILED DESCRIPTION OF WORK:
New V\lOt~ ~-erv i c.e., \, oe. to b ous-e.
New Electrical Meter ____ Second Electrical Meter _____ _
I CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical
Electric
Gas Tank
h lumbing
_Gas Piping
_Sprinklers
Total Sq. Ft of Construction: ______ _
Shutters _ Windows/Doors Pond
Generator Roof ____ Pitch
Sq. Ft. of First Floor: _________ _
Cost of Construction: $ __,!.J.,;::2..:....;:0=--::;0 ____ _ Utilities: _ Sewer _ Septic Building Height: ___ _
OWN ER/LESSEE:
Name Tat\OOC\ \:tQ. me,,,\
Address: YMfo Sunris-e. l;>\vd
City: Fort p i-e,.r-u State: £.L..
Zip Code: o4Cl d-Fax:. _______ _
Phone No. _____________ _
E-Mail: ______________ _
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name:Tia::'Otb~ DDwn,05
~:;:::~: l~~I pgo,J;~-fi~/o~t; C
City: Port St -Lucie. State:li_
Zip Code: 3 4 9 2'. Fax: ______ _
Phone No 71 :a,-877-1 3-5~
E-Mail lumb,o LLG mo.il -UiM
If value of const~ction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC 1s $7,500 or more, a RECORDED Notice of Commencement is required.
1
SUPPLEMENTALCONSTRUCTION LIEN LAW INFORMATION: . -,: " . -'I
.. DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: t/" Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: LNot Applicable Name: Name:
Address: Address: City: City: Zip: Phone: Zip: Phone:
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 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 inspection. If you intend to obtain financing, consult
with lender or an attorne before commencin work or recordin our Notice of Commencement.
Signature Agent for Owner
STATE OF FLORIDA ,
COUNTYOF St . Luy-e,
Sworn to (or affirmed) and subscribed before me of
_L Physical Presence or __ Online Notarization
day of JO-f\u~ . 202 ~ by
TmxttbY Do IN n I()~
Name of person making stateme .
Personally Known / OR Produced Identification __
Type of Identification
Produced _____ ....,..... ___ _ ,Jhl h--W &c~
(Signature of Notary Pu ~tate of Florida )
STATE OF FLORIDA
COUNTY OF St. Lu c (:e
-
Sw.9 rn to (or affirmed) and subscribed before me of
..IL_ P~sical Presence or __ Online Notarization
this ~ day of Thrw 9 . 202 ~ by
T, rno-t:b14 Do w n i 0
Name of person making sta ent.
Personally Known V: OR Produced Identification __ _
Type of Identification
Produced. _________ _
,~rn ~~
_...,..,,..,.'"'> ignature of Notary Public-St~)
commission No . .&..U..J""""'=--..!.=,j~
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
FRONT
COUNTER REVIEW VEGETATION
REVIEW REVIEW