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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: d2 © Permit Number: o Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue, Fort Pierre FL 34982 Phone:(772)4.62-1553 Fax: (772)462-1578 PERMIT APPLICATION FOR: _ ar Address: S 70. S; e_� Oct PropertyTaxlD#: Lot No. 3 �' Site Plan Name: N -l4 Block No. a- Project Name: e 5 �[g (rIx,Y•1 � 4/ T¢7/ mot! 0r �� � t�<�`, i•� ���+. New Electrical Meter Second Electrical Meter R 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:$ Utilities: _Sewer Septic Building Height: Name: Compa n'y":_COu.o it-_/ ek-'.i!,rCd., . a-1/s/y�L FF State: Address: x 36- d Zip Code: 3 Ll I V 2-. Fax: City:��tr _ State:,� Phone No. L 0 �oZ S a5 Zip Code: JfJ2f14 Fax: 77a-ya/-,ifZ: is-Mail: Phone No ,?- V 6 - / — Fill in fee simple Title Holder on next page(If different E-Mail from the Owner listed above) State or County License c S'/,,S"Q 00 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. Jf value of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required. ems. itai:. �w 1 � 3x x o �N DESIGNER(ENGINEER: Not Applicable �` � '; Name: MORTGAGE COMPANY: �[ Not Applicable Address: Name: City: State: Address: Zip: City: Zip Phone: State: FEE SIMPLE TITLEHOLDER: u Not Applicable BONDING COMPANY: Name: T !'Not Applicable Address: Name: City: Address: zip: 7 Phone: City: 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 1 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 5t. Luce County and posted on the job site before the f rst inspection. If you intend to obtain financing, consult with lender or an attorne before Commencing work or recordin r, our Notice of Commencement. igna re of er/Lessee/Contractor as Agent for Owner Si ure of Contractor/License Holder STATE OF FLORIDACOUNTY FLORIDq�� r COUNTY OF �� OF ,4 Crl� Sworn 13JGr affirmed}and subscribed before me of Sworn t for affirmed)and subscribed before me of ysical Pres c r Onl- a Notarization this day of �\.t hysicai presence or Online Notarization Z[77�by this�day of �U L- by '� boa s sk IC T� s SIL�itc� 2�1 Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known Type of Identification OR Produced Identification f ' Type of fde�!#ification Pro ed IDJAPIb (Llct U Produced�lot-t oft ©l-1 UE'Q.. bGLrf' nature of Notar ubric-S Florida i ature of.Nora lit-Sta arida} Commission No. g�LANDOVAZQUEZ LA,NDOVAWUEZ V o - hotar gj)--State of Florida Commission No. v,�,'. I� r Ccmmisslon GG 189841 6 Nota State of Flt>r V. Comm.Expires Feb 26,2022 � CpmmVssion GG 189841 "bonded throua Comm.Expires Feb Zt3,Zb22 ,r:., ASsM REVIEWS FRON G SUPERVISOR PLANS VEGETATION 'gnnded throu9 COUNTER REVIEW REVIEW REVIEW REVIEW MANGROVE PATE REVIEW REVIEW RECEIVED DATE COMPLETED ev.