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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:-;-I IZI L1 Permit Number: e e c la e"o ra -z-'', Building Permit Application Planning and Development Services / Building and Code Regulation Division Commercial Residential ✓ 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax:(772)462-1578 [ON FOR: PROPOSED IMPROVEMENT LOCATION: W sL Address: 9% '/QOUA QA Dr.ve- 7-0��. Po�, Pt, M9151- PropertyTaxlDft: 1s11- 8I1 • ©OO(O• (900 .3 Lot No. Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION OF WORK: rs,e�i I11-� CAM_ 1i1C2 RVUz 2 Sion 15 5 SF� 2 qoi "- IL*'1gz0A'StW9' aJI11K*1 : eAir361 :�sTkNtaSt 4 !CW �ftQ-"� • zo tl to id Z�-1 New Electrical Meter Second Electrical Meter (Affidavit required) CONSTRUCTION INFORMATION: AdditiiooAal 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:T Sq. Ft.of First Floor: Cost of Construction: $�S C 0 Utilities: _Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name tk. \ Zcli, _ Name: _J>AIVeA S1A*w%(PL Address: -ZPk Oc Or. Company: S :r n a s\• City: _,Fe saA Address:SPo 9.c„x 19 -4' T Zip Code: 345 51- Fax: City: J DN�Spr gg ea,6 State; CC. Phone No. Slot - BSI . 7,5BC7 Zip Code: 3►lgS2 Fax: E-Mail: _ Phone No -4= • 335''! Fill In fee simple Title Holder on next page( If different E-Mail tr,4o S. Al r -tiprkrEI ben 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$7,500 or more,a RECORDED Notice of Commencement Is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State:_ City: State:_ Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that no work or installation has commenced prior to the issuance of a permit. St.Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules,bylaw;or and covenants that may restrict or prohibit such structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply. Inconsideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work in accordance with the approved plan$,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 jobsjte before the first inspection. If you intend to obtain financing,consult with lender orne before commencin work or recording our Notice of Commencement. Signa Or r/Lessee/Contractor as Agent for Owner STATE OF FLO Ipq COUNTYOF U�CwA_�'!\ Swor o(oraffirme an subscribed befor me of Physical Presence or_Online Notarization this-1day of ii, 20�by Name of person making statement. Personally Known Produced Identification_ Type of Identification ed iSig4arure of Notary Public-State of Flarida) Commission No. -7 (Qj-' (Seal) 'ta' a Koury Puaec state a Fwoaa Katherine Caltlero Vy Gommist.,GG 11957- ��ran E.OVBF oli]ago]J REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev