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HomeMy WebLinkAboutSancho Building Permit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 4 i2212", Permit Number: Building Permit Application Planning and Development Services Commercial Residential Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: \r 1 W\033VI1 x PROPOSED IMPROVEMENT LOCATION: Address: � `1 Lot No. Property Tax I #: �Jyl " �J3�- Q Black No. Site Plan Name: Project Name: DETAILED DESCRIPTION OF WORK: 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: $ Ril q 00.00 Utilities: —Sewer _Septic Building Height: OWNER/LESSEE: Name _ Address: LA) ) �C C"YUS +A OUP City: State: FL Zip Code: 3LCk Fax: Phone No. -1`1L E-Mail: 1 1no, 1 hG�1r1"101►1 • C C��Y1 Fill in fee simple Title Holder on next page ( if different from the Owner listed above) CONTRACTOR: Name: Company: W\ O 00 Address: 2o City: kA ?'1 ' u( State: FL Zip Code: Fax: Phone No -"- \(\ -C1\0 �- ��'6 E-Mail VQ-h COS C ' (1 CDm State or County License L i r l I 1 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. DESIGNER/ENbINILM Name: NIA Address: City: Zip: Phone FEE SIMPLE TITLE HOLDER: Name: NIA Address: City: Zip: Phone:_ N of State: — Not Applicable MORTGAGE COMPANY: Name: NrA Address: City: Zip: Phone: BONDING COMPANY: Name. NIA Address: City: Zip: mow. Phone: — Not Applicable State: JNot Applicable 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 County makes no repreiiio eaoiwnre ers Associations rulesabylaws or ize and covenants that maydrestrictborprohibit such which is in conflict with any applicable 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 5t. 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 Cou�nt�hand posted on the jobsite before the first inspection. If y rntend to obtain financing, consult with fen'or an attorne before commencing work or recording r'IVotice of Commencement. Sie�turemofO ssee/Contractor Agent for Owner STATE OrFLORIDA COUNTY OF Sworn (or affirmed) and subscribed before me of vP'Physic I Presence or online Notarization this zQa of=AZf, 202� by y n Name of person making statement. Personally Known OR Produced Identification d Type of identification Produced _�-- (signature of Notary Public -State FI id ) Rebekah ploy Commission No. NOTARY PUBL f+ AIT% STATE OF FLOf REVIEWS I FRONNT TER I REVIEW NING 5I LR'1 P COU DATE RECEIVED ©ATE COMPLETED Holder STATE OFTL COUNTY OF 5wor n (or affirmed} and subscribed before me of hysi ! Prese ce or Online Notarization this �y of 202 f by Name of person making statement. Personally Known OR Produced Identification Type of Identification Producedi J►�`. (Signat re of otary Public- State of to Ida) Rebekah Hoy Commission No, IPOTARY PUBLIC STATE OF FLORI i ��XX�C� 2�,/�� 3PLANS VEGETATION SEA TURTLE �V1AIv EV? REVIEW REVIEW REVIEW REVIEW