HomeMy WebLinkAboutA-1 Roof Trusses - Cust. Support Area - AC changeout permit appicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
10 U
Building Permit Application
Planning and Development Services \ / Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1SS3 Fax: (772) 462-IS78
Address:--,�—�--
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Property Tax ID #:
Site Plan Name: _
Project Name: A—
New Electrical Meter Second Electrical Meter
�7
Block No.
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: $/ �. `� Utilities: — Sewer _ Septic Building Height:
Na me LL
Name:
Address: + I
Company:
City. State:i Address:)
Zip Code: Fax:i7Z a`q%�% City:
Phone
M��na� Zip Code:
E-Mail: dSs �j r /rr)3
7` Phone No
Fill in fe simple Title Holder on next page ( if different E-Mail
from the Owner listed above)
State or Co.
usslrann
rJ� Stater
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Fax �7 '_Wi6-9%
'2-3qg- 972 s—
SC
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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.
MEN 11
DESIGNER/ENGINEER: — Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
_
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
nwNFR/ rn1UTDnrrn0 nrCIM111T. .
, , rNN„canon is nereoy 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 representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any 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 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 County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an 11 attorney before commencing work or recording your Notice of Commencement.
Lessee/Contractor as Agent for Owner
ense Hol
STATE OF FLORIDA S)• /, C C�H? STATE OF FLORIDA
COUNTY OF I COUNTY OF �. (tt C i -e
Swoyr� to (or affirmed) and subscribed before me of
✓ Physical Prese ce or Online Notarization
this day of 2021 by
IZL�L;y
Name of persoh making statement.
Personally Known V OR Produced Identification
Type of Identification
Produced
(Signature of No775
mExp"sOS/1012024
State of Flare
Commission No. ssman
m GG 983069
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Sworryto (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this ± day of c U-%2e 202[ by
Name of person making statement
Personally Known V/
Type of Identification
Produced
{Signature of Notary Publ
ommission No.
PLANS VEGETATION
REVIEW REVIEW
OR Produced identification
Notary Public Stab of Flonda
Craossman
My Q-1 Sion GG 993060
9•wn Expires 05/10/2024
SEA TURTLE MANGROVE
REVIEW REVIEW