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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 616 Date:a- f Permit Number: v O S`1 L i�LLL Building Permit Application o a ,N Planning and Development Services Building and Code Regulation Division Commercial Cesildential 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: PROPOSED IMP,ROVEMENT,LOCATION;:.. Address: J�7 �� St Property Tax ID #:.3 # ''f""��� 0 0 —0 Lot No. � Site Plan Name: = V1/ Block Noc�"� Project Name: �%�` Q DETAILED DESCRIPTION OF WORK: New Electrical Meter -- Second Electrical Meter CONSTRUCTION .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: $ Utilities: —Sewer _Septic . Building Height: OWNER/LESSEE:'' CONTRA�CT_OR" Name Name:—c�dQ�a Address: ompany: Cv,ls�rc-u��`c�n nv City: l) State'��' Zip Code: ' 3 Fax: Phone No. Address: d ��L d �� d-e �% 'ESO . City: Stater Zip Code: �>` t30 5 Fax: Phone No ffmb 554 E-Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail Va i-,c e4 :`, u, State or County License VG UC U wIMuuuwn ib cavu ur more, a KrLUKUtu ivonce of commencement is required. If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. Ilk .SUP PLE',.M:ENT-.AL,�CONST,RO.C-,TI.GN,"� LJENIAWJNFOR�pbk-, DESIGNEW�NGINEER: Not Applicable Name: 14 h tl 4 14A A4-- e P,4 MORTGAGE COMPANY: _Not Applicable Name: ddress: Address: City: State: City: State: Zip: �2 V�?,ee; Phone `7 9,,-) Z/9 1W9 Zip: Phone: FEE SIMPLE TITLE HOLDER- t--*IK'ot Applicable BONDING COMPANY: t_of Applicable Name: Name: Address: Address: City: City: Zip: Phone: 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 ancovenants 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 I 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 you i p roperty. A Notice of Commencement must be recorded in the public records of St. Lucie County and post d on the jobsite before the first inspection. If you inttd to obtain financing, consult with lender or;In ttiw eV before commencing work or recording your lVqtir-k of Commencement. Signature of Owner/ LAs- EV/Contractor as Agent for Owner Signature of Contractor ense Holder 4 STATE OF FLORIDA 4 STATE OF FLORIDI� COUNTY OF 7371, - X-) COUNTY OFF C;,t Sworn to (or affirmed) and subscribed before me of Z- Physical Presence or nline Notarization this 19-D of day 202ff by Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization this -'�6 day of 44,9_; 202jIll by Name oirperson—ma in—g-statement. t Personally Knoviktt�R!J_ -(�tQQRl%%';ftQMQifi1tion Type of Identifi * Commission # GG 297802 A 10 :,4r Expires February 23.20 ProdL;PeIT') OFF%-w' T B Name of person making statement.0"' Personally Known OR PP2dR0VAEbWi6Jon Type of Identifica*t1i Commission # GG 297002 Pro djjeetl�, res-Feb ary 23,2023 OFF nda got Notary servIc" (Signature of Notary Pub c- State of Florida) (Signature of Notary P lic- State of Florida Commission No.0 ©`('Seal). Commission No. 47041 '7 V c9_ (Seal) REVIEWS FRONT COUNTER ZONING REVIEW SUPERVISOR REVIEW PLANS REVIEW VEGETATION REVIEW SEATURTLE REVIEW MANGROVE REVIEW DATE RECEIVED DATE COMPLETED Rev. 5/6/2U