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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICA LE INF ))MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: o� o Permit Number: a, `� - cs 14 nn nnn RECEIVED o FEB - 3 2021 ° Buildin Permit A lication g p p Permitting Department st, Lucie Cou tY 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 Address: Property Tax ID #: Site Plan Name: Project Name: _ New Electrical Meter Second Electrical Meter Additional work to be performed under this permit -check all that apply: Mechanical _ Gas Tank —Gas Piping _ Shutters Electric _ Plumbing _ Sprinklers _ Generator Total Sq. Ft of Construction: / Cost of Construction: $ Name Address:"O/d'o City: p����'G State: Zip Code: t� 7�� Fax: Phone No.�- E-Mail: Lot No. Z? Block No. JVVinclows/Doors — Pond Roof Pitch Sq. Ft. of First Floor: Utilities: —Sewer —Septic Building Height: Fill in fee simple Title Holder on next page'( if different from the Owner listed above) Name: Q,roivQ2L Company: Address: City: State: Zip Code: Fax: Phone No E-Mail State or County License if value of construction is 2500 or more, a KtI.UKUCU IVUUGC VI l U111111cIR y--•• if value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. 1 �Q i'� ` 'iL "/"�O; a 4U - ' x�'©" . -L'i. , 'E . - jIN.� 1. -I � q ff . MORTGAGE COMPANY: _ Not Applicable Name: DESIGNER/ENGINEER: — Not Applicable Name: Address: Address: City: Zip: Phone State: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: Name: _ Not Applicable BONDING COMPANY: _Not Applicable 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 therork 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 jobsite before the first inspection. If you intend to obtain financing, consult .:aL. A .... + hr_nfo r^w rncnrina Wnrie nr rarnrdina vnur Notice of Commencement. Q Signature of Owner/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 5�r.A-tee COUNTY OF Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization Physical Presence or Online Notarization this 3 day of t ear- 12020 by this day of 2020 by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identificati n Type of Identification Produced �L L� Produced -- (Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida ) Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.5/b/2U