HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLrCAINON TO BE ACCEPTED
Date: I -1, bI I Permit Number;
Building Permit Application
Plarmingand AewClopmeni ScrOres
8ij0dir+t7GrldCodeRegW0V013ViwFsj0a Commercial Residential
2300 virgrnra Avenue. Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax; 1772) 462.1578
PERMIT APPLICATION FOR' Fzuo-
Address: 10 37 01 T R _ I-- _+F_o �t� Ps a J'Vk FL- 17--
Property Tax If q: ! Lot No.
Site Plan Name; g-,jfq- _ 81cick No.
Project Name- Fen i 'f.m* KArS,
New Electrical Meter i' 0 Second Electrical Meter O
Additional work to be performed under this permit - check all that apply:
—Mech$nlcsl —Gas Tank _ Gas Piping , Shutters _ windows/Boors , Pond
— ElectrlC _ Plumbing —Sprinklers
Total Sq. Ft of Construction:
Cost of Construction; $
Name B&AF L
&fD
Generator Roof Pitch
Sc. Ft. of First Floor,.
utilities' —Sewer —Septic Building Kerg+ht- - - -
Address: r,o]o f } XY- Un pN _
City: t-r tPs gp--P- State; F-
Vp Code; '���_ Fax=
Phorle Na, I110 7L( 'Z. I +LQ.
E-Nlail; b to ke fist ZL (k srna, ( . ro,,, _
Fkll in fee simple Title Holder on next page I if different
from the Owner Misted above]
Name' +f✓ t"''
Company;
Address' —
City: state:— _
Zip Code. Fax,
Phone No
E-Mai I
State or County License_. _ _ _ _ - -
11 Value of CnnstruCtiOn is Z50D or morn, a RECORDED N-nti[e of Commencement is required.
live I ue of HAVC i# 57,500 air more, 0 RECORO M Native of Commencement is required-
DESIGNERIENGINEER: C Not Applicable!
Name -
Address:
City: State,
Zip: Phone --
FEE SiliIPLE TITLE HOLDER: C Not Applicable
Name:
Address:
city
Zip' Phone:
MORTGAGE COMPANY" X Not Applicable
Name:
Address:
city, "State: -
zip: Phoney:
BONDING COMPANY:*_Not Applicable
Name: _
Addrew. _--
City:
Zip: --- Phone:_
OWNER/ CONTRACTOR AFFIDVIT: Appkatron rs hereby mrde to obtain a permal to do the walk and installatkon as Indicated.
1 srftify that no ywotk or installation has commenced prior to the issuance exl a permit
St. Luc be County makes no representation that is granting a pernsrt will authorile the put rrMI holder to build the subject structure
which is in conflict with any applicable Iiome 0*iler% Asvxialion rules, bylaws or and coven anis that mdy rest6cf or peoh�bit such
,truaurc. Please conw-uh mth your Home Owne`n As-,ociawn and review your died for any restrictions I ch rnayapply.
in Consideration of the grinIing of this requested permit, I do hcrcby agree that I will, in aiJ respi:CtS, perform the work
n accordance with the approved plans, the Fiotida HuPldrng Cados and St. teicie County Amen-dmentS.
The following building permit applications are eKempt from undergoing.) lull conCurrency review. room addi0ans,
ace.essory Structures, swimming pools, fences, walls, sggns, Screen rooms and acceiWry uses tvanother non -resrdentiat us-e
WARNING TO OWN ER: Your failure to Record a Notice of Commencement may result In payl rig twice for
amprovernents 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 W obtain financing, consult
with lender or an attorney before comme raring work or record ingyou r Notice of Corn mence.rrlent.
SiSnatura of Dwnerf L#sseerlContracior as Agent for Owner
Signatures of Coril Fact of/ircense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY Of '�" tic.' COUNTY OF
S to (Or affirmed) and subscribed before! meof
__ Physical Presence or Online Notarization
this I!— day of ttook -i 20 by
i;LA IBC. rnaa14-l%CA()
Name oI person mikin Statement
Personally Known OR Produced I{ieritrfication
Type of Identification
Sworn to (or affirmed and subscribed before• m-f Of
_ Physical Presence or Onlinef Notarization
this T day of 70_ by
Name of person making statement.
Personally Known pR Produced Idenlificat+-on --
Type of Identification
Produced
lSigngure ofi Notary Public- t '4 lotl061t psv+r a i+aw. SiSi�xure of notary Public- State 01 Florida
. Main 3 1
Commission N0, 4I�1' o �; % at+aa►r mrriission No- (Seal]
0`111 OR
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUPOTER REVIEW REVIEW � REVIEW REVIEW REVIEW AEVIE►lY
COMPLETED
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