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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 3J(� J Z-�z-) Permit Number: 1: L On, L ° b' t, 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: �CMOy� � � �ICL �!• 0� � �N -- PROPOSED IMPROVEMENT LOCATION: Address: 1 6 0 PJ $I�LI 4f:? IOLS-T L><NL 3 9 Q Property Tax I D#: 3 Z�- �-D .- © o Z ^O D P) _ Lot No. Z Z Site Plan Name: Block No. Project Name: ( _1o) l)CC',I �G� l L DETAILED DESCRIPTION OF WORK: aSS o C r iJ_ rep uC L'9 k 11tk3 C r >n_c' SS' x x L( las C ��o��-- N n m3 kc — New Electrical Meter Second Electrical Meter TRI�C T ION INFORMATION: TiO 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 tr Total Sq. Ft of Construction:WA' S6 �5�1 k Sq. Ft. of First Floor: Z,93 2 Cost of Construction: $ � DOO .— Utilities: —Sewer —Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name ot L, Name: 4e1' Address:InI SFAL 1C155 /LQ_ Company: )D R_ City: ,�nn State.-a— A Zip Code: �l Fax: City: Stater one Nro� d — 1 Zip Code: 3�1� Fax: 03s E-MaTI '' t. �2 �C15s r Q -� Phone No Fill in fee simp Title older on next page(if different -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. 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 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 improve is to your property. A Notice of Commencement ust be recorded in the public records of St. Luci o y and post he=obsite before the first ins ion. Ify =�oobta financing, consult wi I deroran orn mencin work or ec rdin o r mencement. ignature of Owne Lessee/ ntractor as Agent for Owner Signature of o acto icense Holder STATE OF FL 1�0 STATE OF O DA COUNTY OF �—•n�'i-i%� COUNTY Sw rn to(or affirmed)and subscribed before me of worn to(or affirmed)and subscribed before me of . -�.--tip--- . Physical Presence or Online Notarizatiog1 V Physical Presence o Online Notarization! N thisl,v qayof HCA by :: o N 'this ay o !C. ' by I `a-96 cA rL'� (�, : - o v Name of person maki g statem nt. ? ',Name of person making stateme A. < ; it s " o Person ly Known OR Produced Identification�L Persona y Known OR Produced Identificatioi w�F ww L Type Identification ;Type entification ' T o o Pro ed _ = ;Pro d L ' z z t i Si nature of Notary Public ate of Florida I' ( g Y ) �_ (Signature of No Notary Publi S to of Florida) Commission No. Seal ` ( ) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.