HomeMy WebLinkAboutBuilding PermitAII APPLICABTE INFO MUST BE COMPLETED FOR APPLTCATION TO BE ACCEPTED
Dare: b -3g ?\Permit Number:
uOULTirY" H
Li L u Li t lr Ii-''--.-Building Permit Application
Plonning and Development Services
Residential VBuitding ond Code Regulotion Division COmmefcial
2300 Virginio Avenue, Fort Pierce FL 34982
Phone: (772) 462-L553 Fax: {.772l, 462-1578
PERMIT APPLICATION FOR:
PROPOSED I M PROVEM ENT LOCATION :
Address: iO GurTrlA t a.cE
Property Tax lD #:
Site Plan Name:
Lot No
Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Pep\c^r.n^er-t cF 3.S {onr \(> k^p i\ S<,er
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION I N FORMATION :
Additional work to be performed under this permit - check all that apply:
pMechanical
-
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 : S ?k-Q ,c> C Utilities:
-
Sewer
-
Septic Building Height:
lf value of construction is 25O0 or more, a RECORDED Notice of Commencement is required.
lf value of HAVC is 57,500 or more, a RECORDED Notice of Commencement is required.
OWNER/LESSEE:
Address:
city: Pot-\ S t- Lt ci q State: _E!
Zip Code: 3q 1Se Fax:-
Phone ruo. EG o -s-? (- Lztz
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Zip code: 3,1182 rax,
E-Mail Com o lx i I Cq I ;nqa<a he ul ;
State or County ticense C*{ t63-o*3e
I.co"
LucltLr
Phone No
SU PPLE M E NTAL CO NSTRUCTION LI EN LAW I N FO RMATION :
DESIGNER/ENGINEER: Y, Not Applicable
Name:
Address:
City:State:
zip:Phone
MORTGAGE COMPANY: :/2NotApplicableName: I
Address:
City:State:
zip:Phone
FEE SIMPIE TtTtE HOLDER: y2 trtot Applicable
Name:
Address:
City:
zip:Phone:
BONDING COMPANY: V?Uot Applicable
Name:
Address:
City:
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 Countv makes no representation that is erantins a oermit will authorize the oermit holder to build the subiect structure
which is in conflict with anv a'policable Home Owiers Asiociation rules. bvlaws or and covenants that mav restrict <ir orohibit suchstructure. Please consult with lour Home Owners Association and review'your deed for any restrictions vrihich may apply.
ln 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 before the first inspection. lf you intend to obtain financing, consult
with Jender or an attor commencing work or record r Notice of Commencement.
tractor as Agent for Owner
STATE OF FLORlDAr,,r ., \
couNw oF V L( )4{
Sworn to (or affirmed) and subscribed beforeme of
thisrlL'aayor o.fOA-Z,zoLlov _ Physical Presence or _ Online Notarization
Name of person making statement._
Personallyfno *^ ,---#;
DATE
COMPLETED