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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ' Permit Number: © l 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 PERMIT APPLICATION FOR: Wkyv PROPOSED IMPROVEMENT LOCATION: �w Address: Q -10 � i+-- L 34q Ll0' Property Tax ID #: ('H01 00-I000q Lot No. Site Plan Name: . rv) S COV - L�► ,,� l.4 I Block No. Project Name: DETAILED DESCRIPTION OF WORK: Qh New Electrical Meter Second Electrical Meter (Affidavit required) CONSTRUCTION INFORMATION: Additional 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: Sq. Ft. of First Floor: Cost of Construction: $ 01600 Utilities: —Sewer —Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name 1W4r�r�� 0 Name: Address: I c-•�i Q(/ J_Vl -6&'be� a- Company:ribuyi City:ttecrtiLilw Stater Address:3%V� Zip Code: �W qq Fax: City: 'Alm WIN State: PL_ Phone No. Zip Code:"61 Fax: E-Mail: Phone No 4 Ll rb, Cb-1 Fill in fee simple Title Holder on next page ( if different E-Mail rmyy b e cnrAo--toY740,. ( ory) from the Owner listed above) State or County License . 1 30) O2�-IDq 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: P e Zip: Pho FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: Name: _ Address: Address: T 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 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 jobsite before the first inspection. If you intend to obtain financing, consult with ;NT attorney before commencing work or recording our Notice of Commencement. Signature of Owner/ Lessee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF 01 QD tKZ6U_ Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization this __ day of 20,'n by Name of person making statement. Personally Known OR Produced Identification ype of Identification Produced (Signature off otary Public- State of Florid �J MARY BROWN �,, Commission No. (S k0`� °° ;Notary Public -State of Florida - +- Commission # HH 37071 My Commission Expires ���' �ii�� `• Au Ust 26, 2024 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED _ DATE COMPLETED ev 577i572