HomeMy WebLinkAboutBuilding Permit APPAll APPLICABLE INFO MUST BE COMPL ED FOR APPLICATION TO BE ACCEPTED
Date:
•� 1`i iaY ��f �r
Planning and Development Services
Building and Code Regulation Division
Permit Number
Bia. lding Permit Application
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Commercial
New Electrical Meter Second Electrical Meter...,-.
Additional work to be performed under this permit — check all that an ply:
Mechanical
Electric
Nwho"Womb-*
Total Sq., Ft of
Gas Tank
_Plumbing
Construction.,40
Cost of Construction
_ Gas Piping
_Sprinklers
Shutters
Generator
Sq. Ft. of Fir
Utilities: Sewe
Residential
Windows/Doors _Pond
Roof Pitch
st Floor:
r _ Septic Building Height:
-a
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
41
if value of HAVC is $7,500 or mare, a RECORDED Nofice of Commencement is required.
i
SUPPLEM=EN%AL Cafi�STRU
DESIGNER/ENGINEER.,
Name: Ar:
Address: �� L
City:
Zip: IL} �
Phone
r---wEE SIMPLE TITLE HOLDER:
Name:
Addressil,
C*ty4JF
Z10
PMFEPEW
Phone
Not Applicable MORTGAGE COMPANY: Ot Applicable
Name:mods
State: �(.
"Not Aommompplicable
OWNER/ CONTRACTOR AFFIDVIT. Applica
� canary tnat no work or installation has
St. Lucie County
which is in conf{i�
Address:
City$ State:
Zip: Phone:
BONDING COMPANY: I&W Not Applicable
Name: INNIJINIJIN
Address
C1 ty
Z I P
PAW
Phone,---
t ion is hereby made to obtain a permit to d the work and installation as indicated.
commenced prior to the issuance ot a permit.
mak-es
with anX arepresentabonlcbthat
wgrantingrcr permit �Vial� ah�horize the�permit holder to build the subject stru�
structure. Please consult with your Horr
in consideration of t
in accordance with t
he granting of this r
he approved plans.,
The following building perm
it applications are exempt fr
accessory structurPJcz lzihnmmi„_
e Owners Association and reviewyyour deed any�restr[ctionmay
hmay or
apply.
Proh1b
equested permit, I do hereby agree that I will, in all respects, perform the work
the Florida Building Codes and St. Lucie County AmAnrimAn+Ic
IF
om undergoing a full concu cy review: room additions.,
:ture
it such
-------� s N����. �C���e�, wars, 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
impravemen s to yourro . rty. A NDtice of Commencement must e recorded in the public records of St.
Lucie Cou and poste:rt t
he jobsite before the first inspection you inten��btain financing, consult
with le r ar an att brnmmPn���e �.,,,.-� ,,.. �,,,...�.,.__ ., ..
-- — — .•���s vvwnvt ICt,,.�.J,1tUi
Y19nature of own-er/ Lossee'/Contractor as Agent'for Owner
STATE OF FLORIDA
COUNTY OF j.t4ci,r ,w
Swann to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this '�o.-day of L,�LUr;,,. 202(t by
Name of person making statement.
Personally Known � OR Produced Identification
Type of Identification
Produced
OeALO
Sig n a t of Notary Public- State of Florida )
JENI
l..FRANCd
Commission Na P�.vpuB�,_ ���G32877g
Commis
« * Expires Ap
ro 129 t 2023
e Services
T9TFOff � BondedThNlk
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
eve 5_161�S�
our ty oT i
ommencement.
nature of Contractorjlicense Holder
STATE OF FLORIDA
COUNTY OF fit(
Sworn to (or affirmed} and subscribed before me of
��Physical Presence or Online Notarization
this �`yh.- day of - - _,>,a„ 2qZ� by1
IIIIIII
Name of person making statement.
Personally Known r OR Produced Identification
Type of Identification
Produced
(Signat "of Notary Public- State of Florida j
� Puy JENNALFRANCO
Commission No. 1�, Bi.
T79
czmMussion It
Q ExpItire s Aprii 29s 2023
e RV %J P 4&1"1-hJ aju�nas
OFFBondedTbW LWOW
PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW _ REVIEW REVIEW REVIEW
1101