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HomeMy WebLinkAboutpermitAll APPLICABLE INFOMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �2_ Date: 4 7, i Permit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue, Fort Fierce FL 34982 Phone: (772) 462-15S3 Fax: (772) 462-1578 PERMIT APPLICATION FOR: �---- PROPOSED IMPROVEMENT LOCATION: Address: 5Z02- !S(_)(\5e--t _JS� mod. Property Tax ID #: Jy D--) - G08 - Owl q 5 -- 000 -,57 Lot No. i Site Plan Name_ �&LC „r1 'vL1C'jer e 'sV 0 Block No. Project Name: DETAILED DESCRIPTION OF WORK. � i t •-mil. St�rvif' _� _ .' New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: Additional work to be performed under this permit- check all that apply: Mechanical Electric _ Gas Tank t� Plumbing Total Sq. Ft of Construction: Cost of Construction: $ k3_ q _ Gas Piping _ Sprinklers Shutters Generator Sq. Ft. of First Floor: Windows/Doors _ Pond _ Roof Pitch Utilities: —Sewer —Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name_Ali &a Name: "AA - 3 Address: 5Zo-2 Suasc ' -F_AyJ Company:. E Q T(le P�, tltL Pc c-- City: -Fie-cc-c- State: F-(- Zip Code:Fax: © Phone No. Address: �5-7 SE Fist I tE'r"eA V - �c i City: CJ�-. L_t3E @e_ Zip Code: 3gCt 'Z- Fax: Phone Novi-U-3-3-7- � Z State: - E-Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail— MCtr1 2A_ 4P I Y eY=�W"1 • 60M State or County License Cif. [L4 a a value or conscrucuon is csuu or more, a t(tcUKUtU Notice of commencement is required. If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. DESIGNERJENGINEER: — Not Applicable Name: MORTGAGE COMPANY: Not Applicable Name: — `Address: City: Address State• City: State: Zip:_ Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: Name: — Address:. Address. city: Zip: Phone: Zip:Phone: OWNER/ CONTRACTOR AFFIDVIT. Application is hereby made to obtain a permit to do the work and installation as indicated. i "certify that no work or installation has commenced prior to the issuance of -a permit. St, Lucie Countteyr makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in corlfiict with any applicable Home Owners Association rules, bylaws or andcovenantsthat may restrict or prohibit such structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in paying twice for improvements to your property. A Notice of Commencement must be recorded in the public records of St Lucie County and posted on th jobsite before the first inspection. If you i�n$itend to obtain financing, consult t. wltl tenc r or an attorney befi'e commencine work or recnrdiriLzu��,r nIF� .en h� E'ntnmS#1rarrs .«.s Of as Agent for Owner STATE OF FLORIDA STATE OF FLORIDA _ COUNTY OF a ,, COUNTY OF 'S-r Gc c S +o n to (or affirmed) and subscribed before me of Physical Pres ce or Online Notarization this day of 2024 by Name of person making statement. Personally Known Z OR Produced Identification Type of lden ification Produced of Notary Commission No. DIANE COLE Notai= State of Florida C Fw # GG 961089 My Comm. Expires Mar 14, 2024 Sworn to (or affirmed) and subscribed before me of _ P,/ Physical Presence or Online Notarization this ZL day of iil�— 202# by Name of person making statement. Personally Known OR Produced Identification Type of Identification Produced Signature of Notary Public State of DIANE Co Notary Pub k - Stal Commission No. -:F `= Cmrmsission Gi IAY Cam. Expires A "woe fed through Natimal REVIEWS ! COUN ERM REVIEW SUPERVISOR IEW � REVIEW � �REVIEAtti�taN � s REVIEW � MANGROVE ��E E 202,