HomeMy WebLinkAboutBuilding permit appAll APPUCABL.E INFO MUST BE COMPLETED FOR APPLICAVON TO BE ACCEPTED
Date,
Permit Nornber:
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Building Permit Application
PfOnn fly and 0evef0prnerrt5ervicEs
6uildingand Code RegutationOivijon Commercial Residential�r�-
2300 Wrginiu Avenue, Fort Pierce Ft 34982
Phone. 1772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: _ � r y
PropertyTaxlD#: 5LJI,6,-LotNa.
Site Plan Narrie: Block No.
project Name-. `� k�, ;�
DETAILED DESCRIPTION OF WORK:
0 1,C
-1 % can CCet r+� iCxn f re,* '•Nt
New Electrical Meter Second Electrical Metercacx ear.,
_ „s u l J L'0 Imo, 4. 4 ��,�,,., ,r.,: c� fay > &s +
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
—Mechanical _ Gas Tank _ Gas Piping _Shutters
Electric Plumbing _Sprinklers _Generator
Total Sq_ Ft of Construction -
Cost of Construction:
OWNER/LESSEE:
Ooii sLk & I'aw-f ire C-6L
Window5lDcors Pond
Roof Pitch
Sq. Ft, of First Floor:
Utilities: _Sewer _Septic
Nam e_�..�,3`,41`,f�, .�1�_
Address:L7,
City: State:�L
Zip Code: _ c q Fax- lP
Phone No.+d
E-Mail: AA fi-
Full In fee simple Title Holder an next page ( if different
from the Owner fisted above)
CONTRACTOR,
Building Height:
Name; Y) n
Company: ' n ,
Address:
Cty, iris . SCa#2:
Zip Code: �1 _ Fax:
Phone NO 3
E-Mailer
State or County License �
If value of construction is 2SOO or more, a RECORDED Notice of Commencement is required,
If value of HAVC Is $7,500 or more, a RECORDED Notke of Commencensent is required,
SUPPLEMENTAL CONSTRUCTION LIEN LAW fNFORMATION:
DESIGN
Name:_ _
Address:_
City:
zip:.._. Phone
FEE SIMPLE TITLE HOLDER
Name:
Address:
City:
Zip: Phone:
Y Not Applicable MORTGAGE COMPANY: � Not Applicable
Name:
Address:
State r City: State: _
Zip: Phone:
E~N t Applicable
BONDING COMPANY. -Not AppIicalale
Nam?
Address:
City: -- -
ZIP: — Phone:
OWNER/ CONTRACTOR AFRIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
certify that no work or installation has commented prior to the issuance of a permit,
5t. Lucie Coun{tyy makes no representation that is granting a permit will authorize the permit holder to build the subjettstructure
which is in cor>#lict with MY applicable Home Owners Association rules, bylaursor and covenants that may restrlctorprohibit such
structure. Please consult with your Borne Owners Association and review your deed for cony restrictions which may apply.
In consideration of the granting of this requested Permit, I do hereby agree that I wi11, in all re5peas, perform tho work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
Thefollowing Wilding permit applications are exempt from undergoing a full concurrencyreview: roam additions,
accessory structures, swimming pools, fences, wails, signs, screen rooms and accessory uses tick another non-residential use
WARNING TO OWNER: Your failure to Record a Notice oli Commencement may result in paying twice for
improvements A your property. A Notice of Commencement must Pe recorded in the public records of St.
Lucie CI Linty d posted on the jobsite before the first inspection, you irrtend to obtain financing, consult
with lende r art attorne efore commencin work or recordinzyour Notice of Commencement.
Sigr¢d"ture of Owner/ Lessee/Contractor as Agent for Owner I $ azure of
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF n COUNTY OF �i.in
Holder
Sworn to (or affirmed) and subscribed before me of 5w rn to for affirmed) andsubscribed beNre me cf
Physical Presence ar Online Notarization _ Physical presence or Online Notarization
this —day of _ 20Z by this day of 202# by
r Y)u n f c- +' Y) r> i �
Name of person making statement. Name of person making statement.
Personally Known 0 OR Produced Identification
Type of Identification
Produced—
(SiffnatyE of Notary Public- State of Florida }
c�
Commission No 7+ -4 `0' d1 hT�ti F B179
CAP res
`& OF
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Personally Known _ OR Produced Identification
Type or identification
Produced
(SignaS�F6 of Notary Public -State of Florida )
Commission No.6-A—
SUPERVISOR PLANS VEGETATION
REVIEW 1 REVIEW I REVIEW
{51 L. FRANCO
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