HomeMy WebLinkAboutBUILDING PERMIT APPLICATION Jul 16 2021- 19:01 Meek & Sons Plumbing, In, 7725892071 page 3
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BEACCEPTED, 4-1Date: [ Permit Number: 0
Building Permi Application
Planning and Development Services
Building and Code Regulation Divisio Commercial Resi Jential
2300 Virginia Avenue,Fort Pierce FL 4982
Phone:(772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR:
r i 1
Address:
Property Tax ID#: /5 - Lot No.
Site Plan Name; I ! r ma Block No.
Project Name:
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h 5 Oalh
New Electrical Meter econd Electrical Meter (Affidavit equired)
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Additional work to be performed under this permit-check all th A apply:
_Mechanical _Gas Tan _Gas Piping _ utters Wi dows/Doors _Pond
_Electric VPlumbin _Sprinklers Generator Roof Pitch
Total Sq. Ft of.Construction: Sq. Ft f First Floor:
Cost of Construction:$ Utilities: ewer _Septic Building Height:
.I
Name Nam 1~J. d..v �t
Addre s: Com ny: ee 1
City: Y1 Q
TXJaj1d Stater Add s:
Zip Code: Fax: City: State
Phone No. Zip de: Fax:
E-Mail: Phor e No 5 - Qvgn
Fill in fee simple Title Holder on ext page(if different E-M i '
from the Owner listed above) Stat r County License
If value of construction is 2500 or more,a RECORDED Notice of Comm ement is required.
If value of HAVC is$7,500 or more,a RECORDED Notice of Commencem t is required.
Jul 16 2021 19:01 Meek & Sons Plumbing, In. 7725892071 page 4
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DESIGNER/ENGINEER: Not Applicable MOF AGE COMPANY Not Applicable
Name: Nam
Address: Addr s:
City: State: City: State:
Zip: Phone Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable BON ANG COMPANY: Not Applicable
Name: Name:
Address: Addr s:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDV :Application Is hereby made to ottain a permit to do d e work and installation as indicated.
I certify that no work or installation ha commenced prior to the issuance f a permit.
St.Lucie County makes no representat on that is granting a permit will au crize the ermit holc er to build the subject structure
.which is in conflict with any applicable Home owners Association rules,birl3ws or andp covenant! that may restrict or prohibit such
structure.Please consult with your Ho ne Owners Association and review your deed for any rest ictions 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.I ucie County Amendrr ents.
The following building permit applications are exempt from undergoing a fill concurrency revie :room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms kid accessory uses to i nother non-residential use
WARNING TO OWNER:Your falli ire to Record a Notice of Commencement may resL It in paying twice for
improve your prop rty.A Notice of Commence nt must be reca Jed in the public records of St.
Lucie unty a posted on he jobsite before the first in ection.If you int nd to obtain financing,consult
wit lender an r b fore c enc' ork or re ording your Notic e of Commencement.
Si nature of Owner/Lessee/Contracl or as Agent for Owner
STATE OF FLORIDA
COUNTYOF—InNtLV
Sworq to(or affirm d)and subscribe I befW me of Physics Iresence or Or line Notarization
thIsJAJdayof 2Qg L by
Name of person makik statement.
Personally Known OR Produced Identification
Type of Identification Produced
isnature'of of Public toOrr r
�y� NofiE12CH2
�-7 'F A "
Commission No.L ( {seal) :byT a�� E •O
REVIEWS FRONT ZONING SUPERVISOR PLA S VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEVI REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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