HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
L LU]CCEL
C �� J I �^,+�.
G Cl, IL, L L, & —` Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-15 53 Fax: (772) 462-1578
PERMIT APPLICATION FOR: kJP(,9 lM Al �- /"�, 41, { /44 A� ff/
PROPOSED IMPROVEMENT LOCATION:
Address: o ff/ 116 V 9DC
Property Tax ID N: Lot No. _
Site Plan Name: Block No.
Project Name: 00 3/L,1-m 517911,414-- C}/�1�E Gb 4—
I DETAILED DESCRIPTION OF WORK: I
L
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
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ ) L/coy " Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: G
CONTRA OR:
Name roc c o / A2
Name: G% v
Address: o oZ / 0/ -^A I AJ
Company: 1t 1^1
City:tate:
Zip Code: 'E2 Fax:
Phone No. P1—
E-Mail:_,,VS m`t /�iy7��lt5g//-,��
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Address: 14d`
City: State:
Zip Code: Fax:
Phone No — /
E-Mail e�0 4Gl-,
State or County License-!fiA /3A0z 510
If value of construction is i5oo or more, a RECORDED Notice of Commencement is requires.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement Is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Not
Name:
Address: State:
City.
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Not Applicable
Name:
Address:
State:
City:
Zip: Phone:
BONDING COMPANY:
_Not Applicable
Name:
Address:
City:
Zip; Phone:
I tion as indkated
cation is hereby made to obtain a permit to do the work and insta
OWNER/ CONTRACTOR AFFIDVIT: Appl ll a
I certify that no work or installation has commenced prior to the issuance of a permit
pe restrict or prohibit such
St. Lucie County makes no repreli ableiHomeaOwnerstAssociatlo^irulesabyllawsior an cove ants chat may to build t� ict or t oh structure
which is in conflict with any applicable erform the work
structure. Please consult with your Home Owners Association and review Your deed or any restrictions which may apply
Inconsideration of the granting of this requested permit, I do hereby agree that I will, in all respects,
in accordance with the approved plans, the Florida Building Codes and St Lucie County revl me room additions,
The following building permit applications are exempt from undergoing a full concurrencY ions, ti>f use
accessory structures, swimming poo
uses to another
pools, fences, walls, signs, screen rooms and accessory hr nortwice for
WARNING TO OWNER: Your failure to Record a Notice of Commencement may rewk In intpaying public records of St
improvements to your property. A Notice of Commencement must be recorded u intend o the
Lucie County and posted on the Iobsite beforethe
first
or record ,ectiof r Notice of Commencement. consult
Signature of owner/ t.essee/w11.1a.....--..---- -
STATE OF FLORIDA ;—�
COUNTY OF �
Sworn'to (or affirmed) and subscribed before me of
Physical Presepyeor T_Online Notarization
this ''rdayof -203/
1� p �OLl
Name of p n making statement
Personal Known OR Produced It
Type o 4entificad
of Notary
Commission No..
660Y3 �
REVIEWS I FRONT
COUNTER
Holder
STATE OF FL
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
—physical Presence or Online Notarization
thiseof
yof 2020 by
Name person m:20R
tement.
Personally Known Produced Identification
Type of Identification _,r
WaryFYtJsc - state a F ada �J. •o RiAF i TOAAA
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d ` Jun 30, 2021 Commm" P GG 976NT
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ZONING SUPERVISOR PLANS VEGETA
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