HomeMy WebLinkAboutBuilding Permit Application FAII AIPPUCARLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date. Permit Number.
9T L LY,Gq,,18
Y'lY , ::: Building Permit Application
Planning and Development .services
Building and Cade Regulation Division Commercial Residential
0 Virginic Avenue, Port Pierce FL 34-982
Phone: ( 46 --1 Fax- 462-1578
PE-RMIT APPLICATION FOR .
Address: If Vi!tij, QQ�:
Property Tax I D #: 2 �n w so, - eco gL Lot N •
3
Site Plan N Y � ,� �. k No.
Project Name#
.... ...... .:.
New Electrical Meter Second Electrical Ater
CONSTRUCTION INFORMATION : '
Additional work to be performed under this permit - check all that apply:
_,_M chanical Gas Tank Gas Piping Shutters Windows/Doors Fond
' rc lri Sprinklers Pitch_
Total Sq. Ft of Construction: , .,Y,... . .. , .. ., . Ft. of First Floor:
Cost C r€ cti P L�t�l� �es� � � � � ��i � il�i€� Height: ��.�
O
� � �.� �; CON R:
Name: y -
D,�,Lyts
L mm _.
VC State. Address-
city:
Zip Code: �x L A�-
� ..T 4 City: _L�� � Stater
Phone No. 15 Zip Code: 3-
Fax,
-Mail: -�
Fill in fee simple Title Holder on next if different E-Maids v
from the Owner listed above) State or County License G-CI- 1--3 � la-
if ----
i value of constructionis 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVCi $ , 00 or more, a RECORDED Notice of Commencement is mq ire .
t -
t
SUPPLEMENTAL CONSTRUCTION LIED LAW INFORMATION .-
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: i a inn ;
Address: Address:
City: State. city: State:
Zip: Phone _ zip: hone:
FEE SIMPLE TITLE HOLDER: � Not Applicable BONDING COMPANY: iNot Applicable
Marne: Name:
Address: Address:
City: city..
Zip: Phone: zip: Phone:
OWNER/CO CONTRACTOR CT AFFI IT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no worlC or installation has commenced prior to the issuance of a permit.
St. Lucie Count .makes no representation that is granting a permit will authorize the permit bolder to build the subject structure
which is in conflict with am applicable Horne owners A so ration rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Horne Owners Association and review your deed for any restrictions which r ay 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. Lurie Counter Amendments.
The following building permit applications are exempt from undergoing a full concurren y review: room additions,
accessory structures, swimming in pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARN I NG TO OWNE R: You r fay flu re to [deco rd a Notice of Commencement may re u It in payl ng twice for
impro ements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection, if you intend to obtain financing, consult
with lender or an attorney before commencing work or recording your 19otice of Commencement.
irrtu f . r� r Lessee/contractor sIgr for Owner Signature of retractorLr'cense Molder
TINE of FLORIDA TATE of FLOAID
COUN L
wovo to (or affirmed) and subscribed before tree of worn to (or affirmed) and subscribed before me of
P sisal Prey a or Online Notarization �_ ysil Pr r
nce r L� Online Notarization
thl day of C t b this day of Oo b
Name of person making s tement. Name of person making aternent.
Personally Known 0 Produced Identification Personally Known OR Produced Identificatioo
Tape of Identification Type of Identification
od u ed Produced �...._.
r
n ure of Notary Pub ;Mate of Florida (Signature' f (Votary Pu ic- Sta " a ugly Puolic Blau of Fkww
y JANA B ADBURN T, Ashy n B Johnston
Commission I' o. � ,� � I � 7Commission Into. �'.� �o. � � � }OM20 4
.F Explres April 15, 2023
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Sanded T[n Bud a Nita ,r1c I
REVIEWS FRONT T ZONING SUPERVISOR 1 lS l PLANS VEGETATION EAT TURTLE
MANGROVE �
COUNTER REVIEW REVI EW REVIEW E REVIEW REVIEW REVIEW
DATE
RECEIVED-
DATE
f
COMPLETED
D I
Rev.
1