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HomeMy WebLinkAboutBuilding Permit Application I � All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: �! do't •CJ®l� �q QM ° u_v- Building Permit Application Planning and Development Services Building and Code Regulation Division COCTI'I' &cia l- Residential r/ 2300 Virginia Avenue,Fort Pierce FL 34982 Phone:(712) 462-1553 Fax: (772)462-1578 PERMIT APPLICATION FOR: P'ROPOS�D IMPR{7UME�NT LOCATION: Address: 1 Property Tax]1 4 0-'--1- -0•1 ' 000L'000L Lot No. Site Plan Name: Block No. Project Name: 11ARMILE' NS',-@RI N OF WORK: ADD New Electrical Meter Second Electrical Meter C�NSTR� CTION INfC�3Rl AT(C+?N -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 yRoof °' Pitch 'Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ Utilities: —Sewer —Septic Building Height: 11VNER/LESSEE: C©NTRACTOR: Name Name: Address: �I 9 Company: City: %. eY'C State: 7— Address:. Zip Code: Fax: City: State: Phone No.7 72— :9"3 Zip Code: Fax: E-Mail: jtldodd!- 21 2/ vmlj /fy¢�•�'� 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 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. F'L 3MNTAL CIDN UCT UN191118NAIREMN _ORMATt DESIGNER/ENGINEER: _Not 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 or an attorney before commencing work or recording our Notice of Commencement. Signature of Owner/Les e Contractor a ent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF S;XV,%-Cj ,, COUNTY OF Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of Physical Prese c or Online Notarization Physical Presence or Online Notarization this-day of 2020 by this day of 2020 by Name of person making statemen Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification T e f Identification Type of Identification P d ced Produced YS' n ure of Notary Public tare of F,., (Signature of Notary Public-State of Florida) `erg•• ill �Y?�s;•., LASHAHNAINGRAM-BANNING Com fission No. _°' '°= MYCO�v1N#GG275060 Commission No. (Seal) *_ a•. �a: EXPIRES:December 20,2022 "r•....•e: -KIM, PijhlicUnderwfiters REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE ;RECEIVED DATE COMPLETED ev. /20