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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLF INFP MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: RECEIVED L UI�LL o J' JUN 0 4 1011 P' BuildingPermit Application pp Permitting Department Planning and Development Services St,Line"County Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 PERMIT APPLICATION FOR: PROPOSED (M,PR�VEMENT,LO;CATIQN .... _._. . .,. Address: �� S /�925,oti �� .�'i�,2�F F 3 v 9f( Property Tax ID#: I-el a 70 a` 0 0© -7 Lot No. Site Plan Name: Block No. Project Name: DETAILED DESCRIPTIQN OF WORK � t 3- �F P4,9 c r TFkt New Electrical Meter Second Electrical Meter (Affidavit required) 1x 1,C NSTRUCTIQN INFORMATION K b Y 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: OWNER/LESSEE CONTRACTOR Name J oy�l SaC 04 Name: Address: 25- � � 0� ��' Company: City: 1% �'j SRC E State: FL. Address: Zip Code: 3 1/9 6 Fax: City: State: Phone No. ?? - �f FS f Zip Code: Fax: E-Mail: 0 So'--/<G T&A?R CoA,1 Phone No Fill in fee simple Title Holder on next page (if different E-Mail 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 LfEN LP►W INFQRMATIOIU .. k ._ DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: 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 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 jobsi before the first inspection. If you intend to obtain financing, consult with lender or an attorney before c encing work or recording our Notice of Commencement. Sign ure of Owner/Lessee/Contractor, s Agent for Owner STATE OF FLORIDA A. COUNTY OF Sworn tp(or affirme and subscribed before me of --,./—Ph sical Presence or Online Notarization this Iy d y of ��JbY O ri f Q C, ' Name 00 rson making statement. Personally Known OR P.rodu ed cation Type of Identificatio Produced ..� III if (Signature of Notary Public-StateVf Florida ) yP�•, AUDREYB.HUMPHREY Commission No. Seal Q �,. MY COMMISSION#GG390817 ( ) �. •o; EXPIRES-.March 6,2023 `"•FoF F;°�' Bonded Thru Notary public Underwriters REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 51201211