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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: `o LlYmL t� Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: PROPOSED IMPROVEMENT LOCATION: Address: Property Tax ID #: � o - Oc - & Lot No. Site Plan Name: 1bLhQqAZ- _ - � Block No. Project Name: I DETAILED DESCRIPTION OF WORK: ?S6z // e aC1�C..� / — / d } = I JELL- of Q ' /4�o5 - V 6 70 T 7 !`rDL 9L) !. �% f 5 -6 00 l©c �r4 R soda New Electrical Meter Second Electrical Meter (Affidavit required) 0 CONSTRUCTION INFORMATION: Additional work to be performed under this permit - check all that apply: _Mechanical _ Gas Tank a Gas Piping _ Shutters Electric _ Plumbing _ Sprinklers _ Generator Total Sq. Ft of Construction: 16 4p Cost of Construction: $ 4 Sq. Ft. of First Floor: Windows/Doors — Pond Roof Pitch Utilities: —Sewer —Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Name:_ Address: C<_) ;. Company: p Y: (w1 City: Stater Address: ,S- I_De4.42r Zip Code: 3VW6 Fax: City: �' State: Phone No. % 7,Q , 6� - �`�� Zip Code: `13yt) 7 Fax: E-Mail: 44• > (,Z _ ,gym Phone No Fill in fee simple Title Holder on next page ( if different E-Mail from the Owner listed above) State or County License IT value or construction is Z5oo 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. I DESIGNER/ENGINEER.- Not Applicable Name: Address: City: State: Zip: Phone Name: — Address: City: Zip: Phone: — Name: Address: City: 0 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 Count makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conXict 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 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 your property. A Notice of Commencement must be recorded in the public records of St. Lucie County and posted *st:Hth�j�,�,bsite before the first inspection. If you intend to obtain financing, consult with lensdiLaa"-,,,attoxii& bef*- commencinR work or recordine vour Notice of Commencernett. Signature of (%wn!Fr1 Cess iractoras Agent for Owner STATE OF FLORID (,I A, COUNTY OF 12, ILL Sworn tor affirmed) ao subscribed before me of Physical Presence or Online Notarization thi'8ay of 20��L by - - - ----------- -- ------- Personally Known OR Produced Identificati Type of Identification Produced (Signature of Notary Public- S tatelof Florida N I N - 0 - TARY PUBLIC Commission No. 'M IS (Seal) !-!STATE OF FLORIDA Comm# GG211428 Expires 4/25/2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE AN {EVE REVIEW REVIEW REVIEW REVIEW REVIEW GRO COUNTER -I I REVIEW