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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE�COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: `V�/• ��8(�5 TM-. L`i�0C'C Building Permit Application Planning and Development Services Building and Code Regulation Division COC1lnlerClal Residential 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 PERMIT APPLICATION FOR: PRCP{3SED tMPRQV ME{�T LOCATION K Address: Property Tax ID#: lol . O�n.Oooa Lot No. Site Plan Name: Block No. Project Name: I DETAILED DESCRIPTION OFWQRK. v r t ! I I New Electrical Meter Second Electrical Meter (Affidavit required) CaNSTRUCTIC}�t [i�EQRATIQ�[ �3 � � � ,� Additional work to be performed 'under this permit-check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Pond f _Electric _Plumbing -Sprinklers `Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ 00D D Utilities: —Sewer —Septic Building Height: CONTRACT©R. 01 Name Address: DCompany: -C r. l X�L r City: 1 `� " ��.- � ����:«<, .'State' Address: � Zip Code: Fax: 'City. .. State: Phone No. 1 '7 03 3�0 Zip Code: Fax: I E-Mail:_ C �-�' i n n r 7 4o QO - - M Phone No j Fill in fee simple Title Holder on next page (if different E-Mail 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.. DESIGNER/ENGINEER: _ Not Applicable M®RTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip Phone Zip: Phone: FEE SIMPLE TITLE BOLDER: _ 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, 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 C unty and posted on the jobsite before the first inspection. If you intend to obtain financing, consult wit n o attorney before commencing work or recording our Notice of Commencement. Si re of Owner/Lessee/Contractor as Agent for Owner STATE OF FLORID COUNTY OF__ �t.Qom. Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization thi.- W day of 41V o 20%-W by Name of person nPaking statement. Person nown OR Produced Identification Type of de tificat-on Produced ignature of otary Public-State of FI ida ) Commission No. (Seal) ;�a'`�' i;= LASHAMINGRAM-RAHMNG W COMAA4SSION#C,G 27 m EXPIRES:December 20,2022 Bonded Thru KotM Public Undawdtw REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 5/20/21