Loading...
HomeMy WebLinkAboutBuilding Permit Applicatlion All APPLICAB INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: a1 Permit Number: �51vo Wcm VN ...6 Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential r/ 2300 Virginia Avenue,Fort Pierce FL 34982 Phone:(772)462-1553 Fax:(772)462-1578 PERMIT APPLICATION FOR: PROPOSED IMPROVEMENT LOCATION-. Address: Zr� L..Lc e_ c� 'T Property Tax ID#: 1 y�- © - Q``ff-__- 'd Lot No. Site Plan Name: pa V1+ Sk ��.[_5 (()ng_ Block No. Project Name: DETAILED DESCRIPTION OF WORK h, L , h.0 0 CZYI t OCW z- 2.f 1 b 5 aq New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: Additional work to be performed under this permit-check all that apply: Mechanical T Gas Tank —Gas Piping T Shutters _�_ Windows/Doors Pond Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: 1.20(( Cost of Construction:$ . �C�i7 �" Utilities: L"Sewer —Septic Building Height:_ OWNER/LESSE.E CONTRACTOR; Name 1A n CA OM r Name: Address: Mo a QSLCA l[) I Company: e ` f City: ba- C_,� State: L Address: ► o_ Zip Code:,?:�q515--.— Fax: City: U C OA State:FL Phone No. 7 7°_ ��7L 3W� Zip Code: f-_ Fax: 3 E-Mail: bbQ 7LZ.D C)C`�f . r"r. L©YYZ Phone No 8W- U3F'21 La(p 2— Fill in fee simple Tale Holder on next page(if different E-Mail b l.f ZZ c'� from the owner listed above) State or County License 150 U I_n If value of construction is 25M or more,a RECORDED Notice of Commencement is required. If value of HAVC is$7,5W or more,a RECORDED Notice of Commencement is rewired. SUPP EME M CONSTRU E�PNBEN LAW W�JRMATI . x ® 31NEER: Not Applicable MORTGAGE COM YlNot Applicable Name- Narne- Address: Address: Ii Cif: State: City: State: Zip- Phone_ „ ..._...__ Zip: Plhone: FEE SIMPLE TALE HOILD -R: Not Applicable BOI4 DING C0 7A-%,• blot Applicable Name: Marne: � �{ Address: Address: ' �< City: City: Zip: Phone: Zip: Phone: �# i OWNER/CONTRACTOR AFFIOVIT:Application is hereby made to obtain a perrriift to do the dvork and installation as indicated. 1 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 wifI authorize the permit holder to build the subject structure it which is in conflict with any applicable Home Owners Asweiation rules,bylaws or and covenants that may restrictgr prohibit such ill structure.Please consult vvrth your House Owners Association and re%6e%v your deed for any restrictions which may apply_ E I In consideration of the granting of this requested perTnk t do hereby agree that t vrdll,in all respects,perform the work h� in accordance Frith the approved plans,the Florida Building Codes and St.Lucie County A mendrnents_ The following building permit applications are exempt from undergoing a fall concurre'rcy review:room additions, I�I� accessarystructures,svAmmin g pools,fences,wails,signs,screen r€soe�ras and accessory�s4s to another non-residential use INTARIVING TO OWNER:Your failure to Record a Notice of Commencement may result in paging price for improvements to your property. A Notice of Commencement must be recorded in the public records of St_ ,:e County and posted An the jobsite before1he first ins L. 'en_ If you intend to obtain financing, consult with lender or all MorriN before cmnmencing work or ecord our Noti e f CovOencement. Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor ense Holder Ccu T OF. _ OF: LO A k5parn to(sir affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of Physical Presen e or Online Notarization 'Physical Pre or Online Notarization this. t n day of 2�20 6y this-ice--aa.y of 207-0 by f° !Name of person making statement. Larne of person malting statement_ dl Personally Known OR Produce Identification Personally Known OR Produced identification,4� ; Type of IdentEmj I Type of lderst� gr� � ....—.. �� Produced {1 Produced 1. {Signature of Notary Publi�c}-SSttaa�te�of Florida) (Signature NofaryyPublic-State of Florida� Commission Alo_�"?�� C1"" r"� (Sea;; Cornrn"sssioat t99a. (Seal) REVIEWS FRONT ZONING SUPERVISOR P Al`'<lS � VEGETATION SEATURTI_l= MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIOJV DATE l RECEIVED DATE COMPLETED rev.576720 MANDI CHANCE 4[NolaryPublic,Stale of Florida QA MANDICHANCE� Notary Public,State of Floridaly comm.expires June 18,2022 My Comm,expires June 18,2022 I1