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HomeMy WebLinkAboutBuilding Permit ApplicationYMEW BE COMPLETED FOR APPLICATION TO BE ACCEPTED All APPLICABLE INFO MUST Permit Number: Date: �-70 9 Ira O o Building Permit Application 114 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: - °•^7Y,lr �',�, .. y �d„'t' . � ,-v � :r%`r .vr� :..'E Y�r "�GKe�Y'J`tc .i�7 "�;;• Y AR^ 2. f r,+d-i S+?,. :att 3 OAT' A1'10' Piz SE®aINPR®ULMfENTLO $'- t 1 •,CSa y u�.lii.• .:u•in .a}Ys+e�Ye'!.C,u) A y',1 P, .�u....a� }.n .. :i ,4 Address: Property Tax ID #:C Lot No. Site Plan Name: 7 Block No. Project Name: IJUEri�s`��M'.�"'��'.�..�`�isto...k �.. 2srt� �.•^',..�r ;fe xiz,^��.�-'.ws�,,�''�;� .. : �'� i...�i�"<�.t`t... rl� Electrical Meter Second Electrical Meter a•-•.1 ' -� n t� 'w - 'Ilry { , e •M"�-Yi�c<f.'r'`ti t€ n"w. �+� ,T.f 4 - • _ t,iMMI�` .-an{2rx.�:•n3.�..4^•��.s�r P�L?e at r,..a�iv�xfrt_•:�a.._.:...�x`w.� �f. .u. 'F3•,.. a`�.� - a�''51.. Additional work to be performed under this permit- check all that apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters — Windows/Doors _ Pond Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ ®© Utilities: —Sewer —Septic Building Height: _ �.[ i N .,y'JYa,�:fi dt � (: .�. y�� ��Y�x.,.i.._ 1 �y�:R-:�.' -+t�1 �R"`LY�,�f �" C �k'#/AL�..Zy �'�{!�.�'.Sn .�h 7 7 +Y � ��`!-Lt�`�T'wrtF �' 1OWNER/LESSEE L.+•o +�Y�.h .. ..%,e.._ ,•.. ��' yrCONTRACTOR �f.�r. Fk, �_w .: dr '� e "clrev 7 {t7:1.` 5`:'`"'4:",'.�GF,i.:Yhrs.a•�JF.*.�..idZfx3.y.usy'.4:r.7.:Y .' A�.'i.�i�.a..*.r.....�7�v+d..�.4.. ^lCi'�. c.•i. Name Name: Address c�si ���r �✓LJ�­ J-i'�• ,Cornpany: j ' p� State: Add`ressi City: - {C ::. Zip Code: i �`�? Fax: City: ; : a<g - State: ; Phone No. lJ I_ 'l_7 C , Zip Code € Fax: E-Mail: �' ,P < ,tt/ 1� ` �' t44, r(A Phone No Fill in fee simple Title Holder on next page (i different E-Mail from the Owner listed above) State or County License 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. "�S n aPPLEM' IE�N�,x`�C®'NR UC'f IN�LIE liN; Pit- p , ;I�/I� DESIGNER/ENGINEER: — Not ApplicableMORTGAGE 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: City: Address: City: Zip: Phone' Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and instauation as rnaiLdLeu. 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 orpprohibit such structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. pI . 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.Coiiimencement may result in paying twice for:---_ , improvements to your property; A Notic�e=o'fC'ommencement must be recorded in -the public records°of,St. Lucie County and posted on the lobsitepefore the first inspection. If you intend to obtain financing, cor .Ullt "b f . m encin work or recordingour Notice of Commencement. t.i with wn er or an (ILL e a ore cv SignatLVe of Owner essee/Contractor as Agent for Owner Signature of Contractor/License Holder , STATE OF FLORIDA " "tA`TE OF fiI�O.L�A COUNTY OF COUNTY OF.�;,.'!.'� Sw n to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of Physical Prese a or Online Notarization Physical Presence or Online Notarization this day of _ 2020 by this day of 2020 by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature Notary Public- State of Florida) (Signature of Notary Public- State of Florida ) Commission No. {.fie om i ion No. (Seal) jIGBISSET o REVIEWS FRONT rX � VEGETATION SEATURTLE MANGROVE REVIEW REVIEW COUNTER REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.