HomeMy WebLinkAboutBuilding Permit Application All API OCABIE INFO MUST BE COMPLE rw FOR APPLICATION TO BE ACCEPTED
Date: 7 1 Permit Number: :)
40
COUNTY-
�. %
d
Building Permit Applications°4 01,
Planning and Development Services
Building and Code Regulation Division Comm@rcia l Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 7 9,0�6 69 4 e4 &
Property Tax ID#: ® s�, d015' " 100-� Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:-
Additional work to be performed under this permit—check all that apply:
:/Electric
Mechanical Gas Tank _Gas Piping _Shutters _Windows/Doors Pond
�P,lumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: sh?Y Sq. Ft. of First Floor:
Cost of Construction:$ ,. e/ Utilities: _Sewer _Septic Building Height:
OW N,ER/LESSEE: CONTRACTOR:
Name /i Name: IL
Address: -71 1- r Company:-SQ `rLf
City: r f P1.C'! r(- State: Address: n
,Zip Code: ���!"l, Fax City: � �'f4 L r - Stater
Phone No. 7 7�_S t 51-07�`� Zip Code: � g 5:q Fax:
E-Mail:/C fir �� 1 7 R�h G '(�n'l_ Phone No `7 7 Z `z 4 ,
Fill in fee simple Title Holder on next page(if different E-Mail C. I
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.
I
r.4-
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:
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 our Home Owners Association and review our deed for an restrictions which may apply.
Y Y Y Y
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 len r or an attorne before commencing work or recordi our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner ign u of Contractor/License Holder
STATE OF FLQRLB, Q STATE OF FLO
COUNTY OF �� / uC x -Q , ' COUNTY OF � .� it , -P
Sw n to(or affirmed)and subscribed before me of S to(or affirmed)and subscribed before me of
Physical Prese e r Online Notarization hysical Pres ce or Online Notarization
this day of 2024 by this day of 2020 by
jrf.JL
Name of person making statement. Name oY person making statement.
Personally Known OR Produced Identification Personally Known�OR Produced Identification
Type of Identl tion Type of Id ntification
Prod + I�GL Produ d
y f�
(Signature of Notary Pu ic-S to of Florida) (Signature of Not
Y tV Notary Public State of Florida
Commission No. I� Commission No. R`4; Danyel Jones ��
Notary fate of Florida
Danyel Jones ?_ �° Expires 07/p4/2023 016
My Commission GG 352016 of n
4j" xpires
REVIEWS FRO PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.