HomeMy WebLinkAboutNew Bldg All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
1300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION: r,
Address: SF ,V,)C I
/�.
Property Tax ID tt: �' �1 - ( jU 1 -1 1 - `-� Lot No. Z
Site Plan Name:C-51- 1 r �`� Block No.
Project Name: Gi 9
DETAILED DESCRIPTION OF WORK:
Concrete permit # 2104-0341
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
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
ff � 9�
Total Sq.Ft of Construction: I L4 410 Sq.Ft.of First Floor: IL}"T
Cost of Construction:$ M 24, Utilities: —Sewer _Septic Building Height: %2'
OWNER/LESSEE: CONTRACTOR:
Name Tr :rA 1- err;s; I r-usf" Fil R7 Name:.' a.�'� �!i',t rL\
36f00 Cnm �; `X
f - r� ,,
Address: +'1'i�4'11.0�l`r3'! ;�I Yc1 Company:`.. ti
City: rq 1A h 0155ee. State: FL Address: I(;�`h tCt ?-i
Zip Code: 32319 Fax: City:, at e State:
Phone No. 35Z-4J06-I11
�I45, _ Zip Coder Fax: 7-�tvS1-Ilt�
E-Mail: Pea'iI'I+l�ir1ci(a�'C "�bl I 1!1 WSW- PhoneNo � - Y(Q'i- /1162
Fill in fee simple Title Holder on next page if ifferent E-Mail 6 S l.�.o `
from the Owner listed above) State or County License
If value of construction is 2500 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.
.NOj 1 _ . 1 .. . Y• + ` ._.'N .tit .r, - • _ ',
OESIGNE ENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: Name:
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Address: Address:
twr•wr�rr�
City: State:
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city: State
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Zip: Phone �
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FEE SIMPLE TITLE HOLDER: �Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
city
City.
Zip: Phone: gip; 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 Cou makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in confli
YY ct with an licable Home owners Association rule;,bylaws or and covenants that may restrict or prohibit such
structure.Please consult wattPpyour Home Owners Association and review your deed for an moons which m apply.
y aY
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 Budding Codes and St Lucie County Amendments.
The following building permit applications are exempt from undergoing a fWI concurrency review:roam 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 'obsite before the first inspection.If you intend to obtain financing,consult
with lender or an att resmmamcing work or recording our Notice of Commencement.
of owner/Lessee/Contractor as Agent for owner Signature of ContractorAlcense Holder
STATE OF FLORIDA r STATE OF FLORIDA r—
COUNTY F T Z w t --
� COUNTY of
Sworn to for affirmed!and subscribed before me of Sworn to for affirmed!and subscribed before me of
Physical Presence o Online Notarization !daylim Prese ce or Online Notarization
is Zlo day of Mot/CL .�48�-bI
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Name of person making statement. Name of person making statements
Personally Known OR Produced Identification� Personally Known 4 OR Produced Identification
Type of Identifi "on Type of Identification
Produced 0 I�. Dn-ve),S Licmse, Produced
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(Signature of Notary Public-State of Florida j ftnaturre of NotAft
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MAR 11A R.
Commisstan Lft
No. -r !Seal Commission No. �'U ommi -
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ondod Thru Troy Insuraaoe 80Q,385-103
REVIEWS FRONT ZONI N PLANS VEC
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DATE
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DATE
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