Loading...
HomeMy WebLinkAboutBaselic Res Building ApllicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: a. ! -2) � a� Permit Number: 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: PROPOSED IMPROVEMENT LOCATION: Address: C_o.skA e. C"C JT[.�n►+�SOv� c� L, �� Property Tax ID #: _-I � ly -7D (- b (s � - b ©©- (4 Lot No. Site Plan Name: 1 Block No. Project Name: � 5eAi c— 4 sk-le-Act. DETAILED DESCRIPTION OF WORK: U New Electrical M Second Electrical Meter CONSTRUCTION INFORMATION: 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: Cost of Construction: $ OWNER/LESSEE: Sq. Ft. of First Floor: Utilities: __ Sewer _ Septic Building Height: Name Address: k1 C-0'e:-� City: State: �L , Zip Code: 3 tk`U-0, Fax: Phone No. O - E-Mail: i 'Z o wwcc�fwam Fill in fee simple Title Holder on next page ( if different from the Owner listed above) CONTRACTOR: Name: Company: 11 0 Address: C,%( C,,o,r&jL,1_ coyysy%,c-,rc.L-, e6w City: State: FL, Zip Code: Ll'7 IL -7 Fax: Phone No qG J E-Mail r\ Coo State State or County License_CC�-13 3 i� 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. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable Name- Address: _ City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: Zip: Phone: MORTGAGE COMPANY: Name:_ Address. City: Zip: Phone: BONDING COMPANY: Name: _ Address: City: Zip: Phone: Not Applicable State: Not Applicable 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 Nome 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 commencin_g_work or recordingyourNotice of Commencement. Signature of Owner/ Lesse ontracto as Agent for Owner Signature of, ont ctor/ ' n e Ho -er STATE OF FLO DA COUNTY OF06 Swv,,Pn to for affirmed) and subscribed before me of Physical Pres a or Online Notarization this'2z2lday of - LV2 vi , 2021 by STATE OF FLO DA COUNTY OF VSwor to (or affirmed) and subscribed before me of oPh sical Presence or Online Notarization this day of 2021 by Name of person making statement. I Name of person making statement. Personally Known OR Produced Identification Type of Identifi tion Produced (Signature of NAry P&blic- State f r Yesenia Peraalta� p * My Commission GG Commission No, C�,?mil " . ail Expires08/22/2022 REVIEWS � FRONT j ZONING COUNTER REVIEW DATE RECEIVED DATE COMPLETED_ ev. S/6/70 Personally Known OR Produced Identification Type of Identification Produced ofXotary W4tilic- State of SUPERVISORRPLANS VEGETATION SEATURTLE REVIEW REVIEW REVIEW REVIEW i Yesenia My Comr Expires t MANGROVE REVIEW of Florida i 251702