HomeMy WebLinkAboutBuilding Permit ApplicationAll APPt1CABLE INMUST BE COMPLETED FOR APPUCATION TO BE ACCEPTED mber:
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Building Permit Application
Planning and Developme'rit Services Residential
Building and Code Rcyu �arianDivis;vn Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: j772j462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: 4-i qn CArce,
PROPOSED IMPROVEMENT LOCATION:
Address: 0 0 �4r1 !� vf-
Lot No.
Property Tax ID 4: 0 Z. ' D o o DOb
Bfock No. —
Site Plan Name:
Project Name:
h,g
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that appiy:
Mechanical — Gas Tank _ Gas Piping _ Shutters _ Windows/Doors ! Pond
Electric _ Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $
Sq. Ft. of First Floor:
Utilities: — Sewer _ Septic Building Height: T,
OWNER/LESSEE: CONTRACTOR:
Name � `t 11-k I LLC Name: J.
Address: '10 S r Company:
City: 6 (he),)_ %.r Ic.S State:6LD Address: d
Zip Code: Z.O;� Fax: City: •
Phone No. �b f - �' 'S3 LS Zip Code: 5415
E-!Mail: Phone No 7 2 - i
Fill In fee simple Title Holder oiFnext pare ( if different E-Mai! G ,
from the Owner listed above) State or CoLinty— 17nssee
H value of construction 6 ZSW or more, a RECORDED Notke of Commencement Is required.
If Value of HAVC is $7,500 or more, a RECORDED Notice of Commencement Is required.
_ Fax:
Z $ -
State j=
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
pESIGNERIENGINEER: Not Applicable
Name: G c.
Address: in 3 LJ
City: tate:
Zip: Y 4 n o 5 Phone e
FEE SIMPLE TITLE HOLDER: of Applicable
Name:
Address:
City:
Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address: State:
City:
Yip: Phone:
BONDING COMPANY: 7 of Applicable
Name:
Address:
City:
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.
re
St. Lucie County makes no representation that is granting a permit will authorize
t awi or he permit holdants that n►aY est Ict or prohibuild the subject bit
which is in conflict with any applicable Home Owners Association rules,
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,
immin —is fences walls signs screen rooms and accessory uses to another non-residential use
accessory structures, swg p
esult In paying tWiCA
WARNING TO OWNER: Your pro failure to Record a Notice of Commencement
. A Notice of Commencement ement must be recorded inthe f
pub records of St.
or
improvements to your p p y
Lucie County and posted on the iobsite before the first inspection. If you intend to obtain financing, consu t
with tender or a# 0acne fore commencn work or recorclinL our Notice of Commencement.
Signature of Owner/ Lessees ractor as Agent for Owner
STATE OF FLORIDAp .
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
�G Physical Presen a or Online Notarisation
this LJ day of N 2024 by
Name of person making statement. :.y."�%`•
Personally Known„^ OR Produced Identif
Type of Identification � X Z
Produced
CIAu�
(Signaturit of Notary Public- State of Florida) " ^
Commission No. (Seal) Z ay o. Z
p � p m
.2 W O
ti N O 1
of Contractor/License Holder
STATE OF FLORIDA _
COUNTY OF r
Sworn to (or affirmed) and subscribed before me of
Phy ical Presence or Online Notarisation
this 2_f tay of 202 by
Gr
ad
Name of person 'Mat.
Personally Known OR Prod
Type of Identification
Produced r 1 D )
(Signature - ate of Florida } , ��
:ommission No. OV I Is (seatj
REVIEWS FRONT ZONING **JjWMe PLANS VEGETATION SEATURTLE MANGR
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
$
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