HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE C,,;...)LETED FOR APPLICATION TO BE ACCEP4.'1.w l ,�
Date: /'3-� �}o�-� Permit Number: �l ur", l.Q lJJ
RECEIVED
O
Building Permit Application MAR O 1 1021
Planning and Development Services Permittivl=unitm�
ent
St. L
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:
Address: /o761 Qv u.-az CY'\ 3
Property Tax ID #:5%/ sin— / (�� —`j~' Lot No.
Site Plan Name: Block No.
Project Name:
���3TALED E}E£�PT4>`4�CF
11�IaE °'f a A3
r
L It,1Xd 1 (a =4 A&ZA n- `l
New Electrical Meter" 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 _ Plumbing _Sprinklers _ Generator — Roof Pitch
Total Sq. Ft of Construction: 2A Ll t> Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: —Sewer —Septic
Building Height: `I5-7 rJcL,,A
C
NTRACT
7stl._+S.roew. � £...2,_..+Vx'2+_rrl'.ii
Name r C
Name: '►�.a�.
Address: � Cw
'Company:
-
City: AVA Q -AV State: _
Address:
City:
State:
Zip Code: Fax:
Phone No. 49 �-3 R?,v
Zip Code: Fax:
E-Mail: &A-,6-V CA RYnbC � -7c b&t) , Ca
hone No
Fill in fee simple Title Holder on next page ( if different
E-Mail
from the Owner listed above)
State or County License
IT vawe oT construction is isuu 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.
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
Not Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit w uu Ll It: WUI N aI -
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
structure. Please consult th with yoiurHie Home Owners ome Owners Association tion andrreviewylaws or and your deed or any restrictions nts that which may arestrict orl. prohibit such
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
"WARMING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE .SOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANcim, CONSULT
WITH FOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
ee%ContraKr as Agent for Owner
STATE OF FLOBIDA
COUNTY OF S 1 -" C,k-1
The forgoing instrument was acknowledged before me
this day of 20&1by
Name of person aking statement.
i
Personally Known OR Prod uced;Identification
Type of Identification
Produced -
Signature of Contractor/License Holder
STATE STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this day of , 20_ by
Name of person making statement.
Personally Known
Type of Identification
Produced
OR Produced Identification
(Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida )
Commission No. a� ���, Commission No. (Seal)
State f Fy VAUGHN
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REVIEWS F Nft�pbor W -. REVIEW REVIEW REVIEW REVIEW
COUNTER
DATE I
RECEIVED
DATE I
COMPLETED
ev. 2/7/19