HomeMy WebLinkAboutBuilding Permit Application - ThompsonAll APPLICABLE
P,
UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
L�! r�L
, Permit Number:
F— �1
• - i
• T y
1 1�
�r
Planning and Development Services
Building Permit Appl0
ication
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462�1553 Fax: (772) 4621o1578
Com ercial
PERMIT APPLICATION FOR : �� Li��;� �s �t ����t,�'F
PROPOSED IMPROVEMENT LOCATION:
4
Address.
Property Tax ID #-6
Site Phan Name
Pro'0
ject Name:
1l3
DETAILED DESCRIPTION OF WORK:
Residential
New Electrical Meter Second Electrical Meter (Affidavit required
CONSTRUCTION INFORMATI0N:
Additional work t b rformed under this permit —Check alb that apply:
dot No
0 — - EP90IIIIIIIIIIIIIM
Block No
_1* 111 4*
Mechanical as an as Piping � Shutters Windows/Doors Pond
Electric
_Plumbing
Total Sq. Ft of Construction:
Cost of ons ru ion:
Sprinklers
Generator
Sq. Ft. of First Floor
Utilities:
Sewer
Roof Pitch
:)ep 1C Building Height:
P
OWNER/LESSEE:
C�NTRACT�R:
Name �1 �l�: �� 5�'
4h
Name:
BMW
Address:MOP
C40
ity: � � Lf e
State: �,
Address: `� / �..tdir
Zip Code: � r Fax.City:
� �' �
State:
Phone No. .�
Zip Cade: � �,� Fax:
or
ai
-
one o
F'ill i"n fee simple Ti#le Holder on next page (
if different
E�Ma',*l Y"CX'r ` U� � c.�� 0MIUy"
�c' N,, � �, l�i;�v�►
—movie&
from the Owner listed above)
State or County License
If value of construction is 2!500 or more, a RECORDED Notice of Commencement is required.
is required
If value of HAVC is $7,500 or more, a RECORDED Notice of Commenceme
nt .
I
f
DESIG ER/
Name:
Addresso
opipp
9
C I ty lop 7
zip: �
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Pplicable � p � MORTGAGE COMPANY: Not Applicable
iln
FEE SIMPLE TITLE HOLDER.
Name:
Address:
1i
_ Not APP
L� Name.•
Address9
:
city** State:
MW
Zip: Phone.
livable BONDING COMPANY: Not Applicable
citys
Zip: PhoneOL
Name:
Address:
co 0
Ityle
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: ApplIcation is hereby made to obtain a permit to do the work and instaiiation as indicated.
certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation #hat is granting a permit wild authorize the permit holder to build the subject structure
which is �n con#fict with anv- 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,,
n consideration of the granting of this requested permit, I do hereby agree that I wit{, in all respects, perform the work
1W
n accordance with the approved pians, the Florida Building Codes and St. Lucie County Amendments.
The 'fo��owing building permit applications are exempt from undergoing a tali concurrency review : room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNFR Your failure to Record a Notice of Commencement may result in paying twice for
improvements to your property. A Notice of Commencement must e recorded in the public records of St.
ucte County and posted on the jo si e before the first inspectron. �f you intend to obtain inancing, consort
with lender pX a attor V before commencing work or recording your Notice o Co menceme
Signature of Owner/ Lessee/Contractor as Agent for (?wrier
a
Notary Public State of Ronda
Kerry A Sisson
M�!~ � SiEExpiresC01122/2024ission GG 950211 QLaR��A f�, ��
UNTY OF h\f�z"s�
v'
Sworn to (or affirmed) and subscribed before me of Physical Presence or
0
this ay o �u .. L. , 20� y ry\A APOOMM (?wWwro 5 s a
Online Notarization
NO
Name of person making statement.
Personally known � ✓ OR Produced Identificationton
Type o entification Produced
S ignature of Notar�r Public- State of Florida
Commission No.
(Seal)-----____.._-------
o�Y Notary Public State of Flonda
� Kerry A Sisson
My Comm'Ission GG 950211
. ''*oF Expires 01/22/.2024
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