HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLEINFOMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: D u a) Permit Number:
LLLLL
A • '` 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
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PERMIT APPLICATION FOR: 7ElfC}n ��
PROPOSED IMPROVEMENT LOCATION:
Address: 04b arA CA' 1 SL, FL c LP5A
PropertyTaxlD#:3L-i-��0�'��03 i��b-�
Lot No. q
Site Plan Name:
Block No.
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Project Name: `j�'��Offi 1
DETAILED DE,
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New Electrical Meter Second Electrical Meter (Affidavit required)
LCONSTRUCTION INFORMATION: - I W,
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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: $ Q400 Utilities: _ Sewer _ Septic Building Height:
Name rm 1\ralil► 1 Name:
Address: a cp\-�Qu Company: ?_'�Ozz�w b2GA"( Cc
City: O �\P,M State: U4 Address: 0
Zip Code: 10S(00 Fax: r— City: %C:
StateAL,
Phone No. qv-4-(.gS- Lpsq Zip Code: ?Asks Fax:
E-Mail: (Iry I;rrr)0/p00 O)CL*ne.-Phone No "]ir-)- 2M-CODS
Fill in fee simple Title Holder on next page ( if different E-Mail ffie(AYIC\nc . \nk) %Citl
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from the Owner listed above) State or County License_EGA'30(�1S^l0
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.
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City:
Zip: Phone
State
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
Citv:
Zip: Phone:_
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:,
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
ate:
_Not Applicable
OWNER CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicates.
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 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 on th0jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or recording your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF Ir! t LC
Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization
this (,p day of 20Q_ by
Name of person mak
ing statement. Personally Known OR Produced Identification
Type o>f entification Produced
(Signature of Notary Public- State of Florida )
Commission No.r 7� L (Seal)
REVIEWS I FRONT
COUNTER
DATE
RECEIVED
DATE
COMPLETED
ZONING
REVIEW
ALISON HANSON
MY COMMISSION # GG 970043
EXPIRES: March 16, 2024
Bonded Thru Notary Public Underwriters
ANGRO
SUPERVISREVIEWOR I REVIEW PLANS I VEGETATION EVIEWI SEATURTEV EWLE MREV EWVE