HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -21 1 120Z1 Permit Number:
0
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 4.62-1S53 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 1 L1gJ-0Mj4fj 4'4
Property Tax ID #: 1301 - toul - 01 - 000-Z Lot No.
Site Plan Name: laor� a Block No.
Project Name: 'e( ' r- )
DETAILED DESCRIPTION OF WORK:
I r o -. "Tr-c-c
1
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 _ Windows/Doors Pond
, lectric _ Plumbing _ Sprinklers
_ Generator Woof Pitch
Total Sq. Ft of Construction: —®
Sq. Ft. of First Floor: 00
Cost of Construction: $ Ln • " a Utilities:
—Sewer _Septic Building Height: l Z'
OWNER/LESSEE:
CONTRACTOR:
Name L'1nr' orcv��L
Name: owner
Address:
Company:
City: r 1W State: rL
Address:
Zip Code: 3 y 9 I Fax:
City:
State:
Phone No. 2-0 d g 4 3 d-
Zip Code: Fax:
E-Mail: Sri �z� . Cowti
Phone No
Fill in fee simple Title Holder on next page ( if different
E-Mail
from the Owner listed above)
State or County License
If value of construction is 7rnn nr morn . DCrnDnCn wi ar__ -s
- -- - ----- -, "'--•.-, - ••--...+.. 1VWLM= V1 a.Vnr{ umument is requirea.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: jrNot Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: 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 efore commencin work or recordingour Notice of Commencement
e
ig tore of Ow
essee ontractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA,
STATE OF FLORIDA
COUNTY OF !�_`=-'r . � UC'�-
COUNTY OF
5wa n to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Prese ce or Online Notarization
�
Physical Presence or Online Notarization
this � day of -_07LV 2024 6y
this day of 2020 by
� inc� s L �