HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date.
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iPe mit Number:
Building Permit Application
1�
Buitding and Code Regulation Division
3 00 Virginia A ven Lie, Fort Pierce FL 34982
Phone: (7 ) 4 -155 i ax: {7 } 46 -157
PERMIT APPLICATION
Commercial
PROPOSED IMPROVEMENT LOCATION;
Address: .2 1/--c _
Pro perty Tax i D ##: ---- y�
Site Plan Nam, e:
Project Name:
DECTAILED DESCRIPTION OF WK:
�- PV VA-11 C�2 k &A cl�
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Addit[onal work to be performed under lthis per-r-nit — chr-ck al I that apply:
Mechanical — Gas Tank � Gas Piping
Elect11c : Plumbing Sprinklers
Total Sq. Ft or C.onstr•u tion:
Residential
Lot No.
B[ock No.
(Affidavit required)
Shutters Windows/Doors �.'-- 1-joind
Generator _ o ; pitC-I
q. Ft. of First H00r:
Cast of Construction:
,__, � _ -Utilities:Sewer � ePTI OUiidin
OWNER/LESSEE:
� dame_)�d
Address:x
City: ��--°
€ Code; wr Fax:
_
Phone , o.
W
State:
CONTRACTOR:
a rn'
Company:—
Address.-
city- y
Zip Cody:
1 r
E-tea iI: Phone No - -
Fill in fee simpleTitle bolder on next page (if different E, ail ��
from the Owner listed above) state or Counter 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.
State �2211
SUPPLEMENTAL CONSTRUCHON LIEN LAW INFORMATION:
DE i E NGINEER- L- Not Applicable
Name -
Address,
City- State
Zip:
Phone
FEE SIMPLE TITLE HOLDER:
Name: —
Address:
Zip: Phone:
MORTGAGE COMPANY: mot Applicable
Name:
Address-
City-, - State:
zip. Phone:
of Applicable BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
OWNER/ CONTRACTOR FFIDV9T.- Application is hereby made to obtain a permit to do the work and installation as indicated.
certify that no work or installation has commenced prior to the issuance of a permit.
t. Lucie Count} makes no representation that is grantinga permit will authorize the permit holderto build the subject structure
which, is in conflict rith any applicable Home Owners Association rules, bylaws or and covenants that may r estrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply -
in consideration ofthe granting of this requesters 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 t- Lucke County Amendments.
The following building permit applications are a errtot from undergoing a full concurrency review: rourrt additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another nor -residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in paying trice for
improvements to your property. A Notice of Commencement must be recorded in the p blif, records of st.
Lucie Cou ty and posted on th jobsite before the first inspection. If you intend to obtain financing, consult
with le are att me b ore commendnLr work or recording yo--jr Notice of Commencement.
Sign a u e of n,ner/ Lessee Contractor as Agent for Owner
STATE 01 11.0RtD�
COUNTY O _...--
Sworn t or afTirme I and sobscr;bed bef e rr;-1 of Physical Presence or li L lotar€ atio3
this dad
Name of person making statement.
personal"y Known
Type of -jd-ergitl.-al
�CR Produced Identification
Produc
Skgatu; c a r ° ` 3 ate oT Florida j
No'
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