HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR -APPLICATION TOBE ACCEPTED ' )
Dater - - )2.3 'U • �� ' Permito( . Number: D 2 • 413
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Building Permit Application a3nl3�ab
Planning and Development Services
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Building and Code Regulation Division Commercial ReSld21'1t18�+
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772Y462-1578
PERMIT APPLICATION FOR: �' ��•
Address:
Property Tax ID 004) 9 _ Lot No.
Site Plan Name: /��:'6a�''�c, Block No.
Project Name:
New electrical Meter Y Second Electrical Meter
Additional work to be performed under this. permit — check all that apply:
✓Mechanical ✓Gas Tank. Gas Piping _ Shutters +Windows/Doors _ Pond
✓Electric ✓ _ .�
_ _ Plu � ngQ _Sprinklers Generator Roof Pitch
Total Sq. Ft of Construction: S Ft. of First Floor: al D
dill c�-W c
Cost of Construction: $ _ _ e—(1 • !7 �� • D 0 Utilities: —Sewer &/Septic Building Height:
Name
Address:_.2o,7a73
City: State: zs/_79 •
Zip Code: _-;5"J"7 Fax:
Phone No.�j,2
E-Mail:_�c1%y� i �rl►?,ei /� lyr,
Fill in fee simple Title Holder on next page ( if different
from -the Owner listed above)
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Name:
Company:
Address:
City:
Zip Code: Fax:
Phone No
E-Mail
State or County License
State:
-- ----- -•--••"••`+ -- •a L wu ul IIlul C, d nCI.VnLJCU IVOUCe OT LOmmencement IS required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
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 prtor:to the issuance,of a permitp
St. Lucie County makes no representation that is granting a permi# will authorize
or and covenants that'.may ruild estricutbor p oFiib t such
which is in conflict with any applicable Home Owners. Association rules,bylaws
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 wor .
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.poois, fences, walls, signs, screen rooms and accessory uses to another non-residential, use
WARNING T0.0VIINER: Your failure to Record. a. Notice., of Commencement may result In paying twice for
P. _.
Improvements to'your property A N'otl"ce, of Commencement must be, recorded m the ubllc records of St.;
Lucie County and posted on the �obsite before the first Inspection If you Intend to obtarn financing, consu`It
with lenderoran'attorne before commencingwork or recordln our Notice of Commencement.
Signature of Owner Lessee/Contractor as Agent for Owner
STATE OF FLORIDA 5)
C.OUNTY`OF G� -�- ` , i �^
Swo-to (or affirmed) and subscribed before me of
Physical Presence or Online Not ization
this ICL day of M I' C , 20�iby
Name of person making statement.
Personally Known OR Produced Identification
Type of Identifica i
Produced 1
A, Ain
(Signature of Notary blic- State of Florida
,`okAp. ?qe<c AUD Y B4y!1UMPHRE-Y
Commission No. MYCOM 09 N # GG 300817
EXPIRES: Wrch 0, 2023 fi
REVIEWS FRONT ZONING I COUNTER I REVIEW I SUPERVISOR REVIEW
V
RECEIVED
DATE
COMPLET
Signature of Contractor/License Holder .
STATE OF FLORIDA
LOU.NTY OF::
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of , 20_ by
Name of person making statement.
Personally Known, OR.Produced Identification
Type of Identification
Produced
(Signature of NotarVPublic- State of Florida )
Commission No. (Seal)
PLANS' VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW