HomeMy WebLinkAboutBuilding Permit Application All AjPPLICABLE INF MUST BE COMPLETED FOR APPLICATION.TO BE ACCEPTED
Date: Permit Number 2197"0 20
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uIldin permit App11cation.
Planning,and Development services
-B,uild►ng"and Code Regulation Division
ComMerelal _ Residential -
23aQ V►rginia Avenue, Fort Pierce,FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERIViIT APPL ICATION�FR":
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Address "
PropertyTax�lp#s � --- �%���� . , "
"�..�1.,1(„/ .�..'° _ Lot No.
Site.Plan Name: -----
' - Block No.
P,rojest.Name:. i'Gc/) C�i ; t-9 nc
DTfILI=i? DESCRIPTIC3N t3F WC)RK
Eliil
5
New Electrical Meter -
Second Electrical.Meter '
(Affidavit required)
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dyyy
Additional work to,be performed under this permit—check all that apply:
_Mechanical _Gas Tank —Gas Piping _Shutters
_Windows/Doors Pond
Electric —Plumbing Sprinklers
— P —Generator _Roof Pitch
Total Sq: Ft of Construction:
So. Ft.of First Floor:.
.Cost of:,Construction $—3Si , 0"J
Utilities:. Sewer _Septic Building Height: '
R/LESSEE `� ONT i a, .
RACT�R
Name i'
Name: t)c
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Add-Tess: 2-3 - : . �. Coin p,an
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City:" G W, �i State: - Adddress: .. { On 4
Zip Coder
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City: 0 t�'� stater
Phone No. _" 1 J �"
Zip Code
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E-Mail: ) triG�Ct cd3
,.. � Phone,No,3
Fall"in`fee soraipfe Title der..On he page(if different E-Mail l-!G'th Ain, 12 �bt,�' X)k, �
•from the Owner listed above)`` State or ounty License '
1#value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
if value of HAV"C is$7 500 or more,a"RECORDED notice of Commencement is required.
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D.ESIG! ER/ENG1NEElt:." ;Not Applicable I1/IORTGi4GE iVQNiPAN1( of i4pplicable,
Name: Name:
Address: _W " City,
City: State'. State
zipPhone' Zip. P
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FEE:SIMPLE TITLE,BOLDER.. Not Applicable BONDING�OIVtPAIiiY: iVot,Applicable
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- Address: Addss: u
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'Phone..'' :Zip: Phone::
WNW GONTItACl°�Et AFFiDi/B'F;Application is;hereby made to obtain a-permit to do.themork and installation as ind`%cated'
(;certify that no.work or installation.has commdneed prior to.the i seance of:a permit.
St."Lucie Coun :makes no,representation that.is granting a.permit Will;authorize,the permit-holder to build,the subject:structuro
which is1n"Conflict with=any,:applicable Home Owners Association:rules;.bylaws or and covenantsthat may;restrict or prohibit"such
.structure..Pi"oase:consult with"your,HomeOwners Association and,review your-deed for.any restrictions-which may apply:
In consideration of the"granting,of this requested'permit;(,.do hereby agree;that(will,in.al[respects,,perform the work
:in accordance with;the approved ptans,the Florida BuildFng Codes'and St:Lucie County Arnendnfients;_
The foftowing building permit appiications;are-exeMptfrom undergoing a full"cohcur rency review room.additions,
accessory structures;swimming pools,fences,:wAl{s-signs,screen"rooms'-and accessory uses to.another'-non-residential use.
WARNiNG:70 OW_ Your failure to>Recprd a,Notice:of Carnmencetnent may result on,paying.twice`for'
mprovements'ta"you-r"property. A Notice."of-Commen`cement.must be.recorded'ia the"-public records,af$t..
Lucie:County and posted.,on the;jo before th"e:first inspection If y6" intend to obtain.financing,consult
with {endero"r"en- ne b e' _Gd6ncin work.or'recordin oui-NotceofCommencement. -
Signature:.6f"Owner/.Lessee/Contractor"as Agent for Owrier
STATE,OF FLORIDA, .
-COUNTY OF
S.wor t (or affix ed and subscribed bef me of, Physical Presence-,or Online Notarization
this "day of 20_ by
'6
Name.of person making"st men "''"
.fly •• �' ,
Personally Known OR Pro p tific , `
T i Idntlfica'tio"n Produced
�gnature of" Puklic,State of Florida)
\.a�tuuerr -
Commission No.HP[T395 (Seal) Al- o 'l IWO
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IP
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA`TURTLE" MANGROVE
COUNTER -REVIEW- REVIEW REV(EW REVIEW REVIE;IN REVIEW
-.DATE. - r ;
-RECEIVED
DATE:
.CO.IMPLETED-
Rev 720121,