HomeMy WebLinkAboutHightower_ Water heater_ Permit Application All APPLICABLE INFO MUST BE
COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �Q � / Permit Number:
P c `°' 1 c L' n, - Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential 1C
2300 Virginia Avenue, Fort Pierce FL 24982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION: G
Address: 5 l�r 'ls, h r L- 5
Property Tax ID#: a &0,2 - Lot No.
Site Plan Name: Block No.
Project Name: lot-
DETAILED DESCRIPTION OF WORK:
C' P � �a"Iem C✓New Electrical Meter Second Electrical Meter (Affidavit required)
FCONSTRUCTION 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: $ l(>( Utilities: —Sewer _Septic Building Height:
OWNER LESSEE: CONTRACTOR:
Name Name:
Addres : Company: ryl_ it 11�
City: State: Address: Q i'\6 L4 CC)
Zip Code: Fax., City: V State: l
Phone No.�7d:7— ( l am�j Zip Code: �_T Fax:
E-Mail: Phone No —
Fill in fee simple Title Holder on next page ( if different E-Mail 1� / r
from the Owner listed above) State or County icense (` (—� J 1 / � j�
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.
FRWRR
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY" Not Applicable
Name: Name:
Address: Address:
City: State: Cite: State:
ll Zip: Phone Zip Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip Phone:
OWNER/CONTRACTOR AFFIDVIT: Application is hereby made:o obtain a permit to do the work and installation as indicated.
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, bvlaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and rev ; your deer for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree t^at. I wili, in all respects, perform the work
in accordance with the approved plans,the Florida Building Codes anc _ Lucie County Amendments.
The following building permit applications are exempt from undergoii g 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 YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER QR AN ATTORNEY BEFORE RECORDING YOUR NOTIPEPF COMMENCEMENT."
Signatur o wneq Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA �r - STATE OF FLORIDA ,
COUNTY OF S�' (�C(� COUNTY OF
The orgQ,ing instru . t w s acknowledged efore me The forging instrument was acknowledged efore me
thiM'`day of 20 by thi &Jay of 20��by
S orb low Jose , &C)UJI 0c�
Name of persoA making statement. Nance of person 6alking statement.
Personally Known X OR Produced Identification Personally Known OR Produced Identification
Type of Identification 1 Type of Identification
Produced Produced
i
(Sign ture of Notary Pu F gna ure of Notary Public St e ofFpc-'r," : APRitBRt1MLEY
Commission#GG 208194 = Commission#GG 2081
0 17 2022 I s Apr817 2022
Commission No. mmission No.
my Fyn htewwwou 800, 7 1 TMu Trey Fain
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19