HomeMy WebLinkAboutStewart,ac permit.apAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: - .Z) Permit Number:
- D Building Permit Application
Planning and Development Services Commercial Residential l/
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
New Electrical Meter Second Electrical Meter
' TI ICTIC3N - ifOF MATl0N'
Additional work to be performed under this permit- check all that apply:
VI/Mechanical _Gas Tank _Gas Piping _.Shutters _Windows/Doors ___ Pond
Electric _Plumbing —Sprinklers — _,__
S rinklers Generator Root ______—Pitch
Total Sq. Ft of Construction: —
cost of Construction: $--
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
Name
Address:'85I (,;;, 6:,A t ( k°t li ,ram
City: Fb (-- - 5t. L--% c State: 4--
Zip Code;3 �l�✓ a Fax:
Phone—
E-Mail:
r- ni in fee simple Title Holder on next page (if different
from the Owner listed above)
CC}R CIO -
Name:
Company: ( %1� 1�2� �(�t►2�' '�
Address- S_
city: �Q'" IrciGt - stater
Zip Code:Fax:
Phone No 1-3�i-2 ,
State or County
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.
FEE SIMPLE TITLE HOLDER: Not Name: Applicable
Address: .
City. -
Zip: Phone:
BONDING COMPANY: Not 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.
! certify that no work or installation has commenced prior to the issuance of a pen -nit.
St. Lucie Counttyy 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. Tease 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 1 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 th�jobsite before the first inspection. if you tend to obtain financing, consult
t_ fblen r or an attorney befl 'e commencing work or recordinLmmir
of Owner/ Lessee ntractor as Agent for
STATE OF FLORIDA STATE OF FLORIDA v
COUNTY OF T Lau c COUNTY OF S' C-A l
Swr to (or affirmed) and subscribed before me of
V Physical Presence or Online Notarization
this � day of Joiji . 202# by
Name of person making statement
Personally Known Z OR Produced Identification
Type of identification
Produced
Sworn to (or affirmed) and subscribed before me of
- ;--' P ysical Presence or Online Notarization
this day of _J (j { �j 202# by
Name of person making statement -
Personally Known V-11 OR Produced identification
Type of identification
{signature of Notary Pu - - iANE COLE
Mari'}��- Sgnature of Notary Public- State of pig COL
O
Commission NO. -- �- State of Florida = Wor]► Public - Stat o tori¢a
. cohwd�Fu it GG 961089 Commission No. Commission # GG
My Comm. Expires Afar 14, 2024 � � Mytamm. Expires Ai r , 2D2,
Bonded h National N Assn. Bonded through National of V Assn
REVIEWS I
COUNTER REVIEW S REVIEWOR REVIEW REVIEWON S REVIEWLE
11IRNVGIERWVE
Enrc