HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2.141 ZL_ 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) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: wait( h-eatr ► nst a u a -h o n
PROPOSED IMPROVEMENT LOCATION: r
Address: �,� `7nlp f)YI VP. Qfir4
Property Tax ID #: 314 LWr 500 — QL450 — O00 ( Lot No. 13
Site Plan Name: ( lot Block No:#_Z-
Project Name: _ N R
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION: —I
Additional work to be performed under this permit— check all that apply:
Mechanical
_ Electric
_ Gas Tank
Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ y 50 . on
_ Gas Piping
_ Sprinklers
_ Shutters — Windows/Doors Pond
_ Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer — Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name irent& iocr
Name: Q
Address: 7
Company: CS c•
Address: �-E 5_
City: State: EL
Zip Code: �J�IrJZ Fax: N I A
City: r+ + MR State:
Phone No. N: A
n
Zip Code: Fax: L' q ` IQ
Phone No m q— C1 t a0
E-Mail: N
Fill in fee simple Title Holder on next page (if different
E-Mail naq -fv)+ (a) muic yi(�r ro of . nN
from the Owner listed above)
State or County License
u. _i. _s_
a n„GL, ,,,vine UT wmmencement Is requires.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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:
_ rr I V L. I %. gym-- i vR mrriuvl i : 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 yo�ntend to obtain financing, consult
wig th le dg�Lr. (Attorney before commencing work or recordiy purr//NNotice of Commencement.
Signature of�C�wner/ Lessee/Contractor as Agent for Owner I Signature of on ractor/License Holder
STATE OF COUNTY OFORIDA�� STATE Lud�e I COUNTY FORIDA
S+ . V.,licit
Sworn to (or affirmed) and subscribed before me of
P ysical Presence or Online Notarization
this day of � 202D by
J A rn' e 'D i Fran CtS C1D
Name of person making statement
Personally Known V,,`— OR Produced Identification
Type of Identification
Produced
(Signature ofl4otary Public- State of Florida )
Commission No. REY N(000k)E HARTFORD
th�Notary Public -State of Floridi
!(*: Commission # GG 362149
REVIEWS
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Sworn to (or affirmed) and subscribed before me of
✓P ysical Pre ce or Online Notarization
this day ofbtlorUaKI . 202J by
Gunn i-e,_ D i Fra.n Cts co
Name of person making statement
Personally Known %,�"— OR Produced Identification
Type of identification
Produced
G�JI,4
(Signature of Notary Public- State of Florida )
Commission No.676352,149 (Seal)
PLANS I VEGETA
REVIEW REVIEI
IC
k he
hFV&Wission
OLE HARTFORD
SMANGA6?V6
# qq�(`�19
July
4, 2023