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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE I FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q Date: v Permit Number: I _ O 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: / 1 6 F v�# Y / PROPOSED IMPROVEMENT LOCATION: Address: cS '� din Property Tax ID M - D® - ©o&S-- Lot No.�� Site Plan Name:.& :% 'mg-' Block No. Project Name: DETAILED DESCRIPTION OF WORK: 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 ,IK Windows/Doors _ Pond . Xi Electric Plumbing _ Sprinklers _ Generator Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: iTk Cost of Constructioti$s Utilities: _Sewer Septic Building Height: - 6-f-- OWNER/LESSEE: CONTRACTOR: met& kO, Name: •, ,. - Adress: 9> Company: fCf�ty: G State Address: t , p Code y Fax: City: g State: one No. - Zip Code Fax: ail: Phone No j Fi �I in fee simple Title Holder on next page (if different E-Mailbi, it r � frog the Owner listed above) tt State or County Licens�f%'7.� 9 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. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: — Not Applicable Name: C G Name: Address: Address: City: State: City: State: Zip: Phone VI'VWFEE Zip: Phone: SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMP Y: Not 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 attorney before commencing work of recording your Notice of Commencement. '/ Lessee/Contractor as Agent for Owner Holder STATE OF FLORIDA STATE OF FLORIDASv COUNTY OF COUNTY OF Lc( Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization Ph sical Presence r Online Notarization this /$ day of, ja , 2020 by this day of 2020 by PAIK Name of person rTYaking statement. Name of person m ing statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identificatio Type of Identifica 'on Produced Produced v (Signature of Notary Public- a (Signature of No "Ye f F16t�� V YP�i� =� nE Ote of Fior AUGHN bComCommission No. 90 SCj F o d, EN VAUGHN mission No. ;,a,F,�oPP•� MY Com V GG 270Public R, �My Commom iO� # �� 27 Pt, lic October 22 n Expires9 111111 tobe_r 22 XPire REVIEWS FRONT ZONING JI'V ANS VEGETATION SEA TURTLE MANGRO COUNTER REVIEW REVIEW IEW REVIEW REVIEW REVIEW DATE RECEIVED COMPLETED