HomeMy WebLinkAboutBuilding Permit Application - Romeo All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date : Permit Numbers. .
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LL `� L Bu *ild � ng Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginio Avenue, Fort Pierce FL 34982
Phone: (772) 462-lS53 Fax.,., (772) 462-1578
PERMIT APPLICATION FOR ;
PROPOSED IMPROVEMENT LOCATION : L4LQ
Address ,,
Property Tax I D #: 4460 2;0* 15t)( • t)(0 2 (Q • COS • 5 Lot No.
Site Plan Name ,* Block No .
Project Name: 0c) �
DETAILED DESCRIPTION . OF,WORK.
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%hj -b %M00
Cl e� .Q.h aid
New Electrical Meter Second Electrical Meter � � 40N EM04k .— If
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CONSTRUCTION INFORMATION :
Additionalworktobe performed under this permit — check all that apply ;
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
_ E l e ct r i c _ Plumbing _ Sprinklers _ Generator oof �_ Pitch
Total Sq. Ft of Constructi: n: 21 2 LP Sq . Ft. of First Floor.
Cost of Construction .* $ � t eko t)& • S'4Utilities: _ Sewer _ Septi c Building Height:
OWNER./LESSEE : CO.NTRACTOR .
Name f�1Y1� � N a m e :
� Address* V Company : 01 co
City: State: Address : CSO
Zip Code : / � Fax : City: stater
Phone No. Zi Code : Fax :
E-Mail :, , Phone No �72—�D� U 2& R>
Fill in -fee simple Title Hoider on next page if different E-MailV I/
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION .,
DESIGNER/ENGINEER, Not Applicable MORTGAGE COMPANY. � Not Ap.plicable
Name : Name.
Address ; Address :
Citv : State . pity: State ;
Zip: Phone aw, zip; Phone :
FED SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY., Nit Applicable
Name : Name :
Address :. Address :
city; City:
Zip: Phone . dip: Phone:
OWNERJ CONTRACTOR AFFODVIT: 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 daunt makes no representatian that is granting a permit will authorize the. permit holder to build the subject structure
which is in conxict with and applicable Home owners Association rules, bylaws or and covenants that 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 cancurrency review: roam additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessary uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Noticein of may result paying twice for
improvements to your properly. 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 attoqrXeV bed ommencing work or recvrdin ur Notice of Commencement.
ignature of Owner/ Lessee/Contractor as Agent for Owner Sii'n'6ure of Co-!n6ra-ct&/License Hodder
TATE OF FLORIDA STATE OF FLORIDA
COUNTY OF .I--
COUNTY OF
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Swo o (or affirmed ) and subscribed before me of Savor (or affirmed) and subscribed before me of
P I Pies e or Online Notarization P sisal Preece or, online Notarization
!t his ay of , 202t by -this d ay of oIV 202N by
N a me of pe rson m a ki ng statem e nt. Name of person making stat nt.
Personally ow OR Pro ced Identification Personally Known R Produced identification
Type of Id ntif cati n f Type 07 tification
Produced Produceddr
(Signatu _ � � �� (Signature o Not - AML
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Expires 0611512024
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVI EVV REVIEW REVIEW REVIEW REVI E1�If
LATE _
RECEIVED
DINE
COMPLETED ,