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HomeMy WebLinkAboutBuilding Permit Applicationr11 All APPLICABLE INFOMUSTBE COMPLETED' FOR APPLICATION-TOrBE ACCEPTED- Date:Permit Number: n '� 9`uo 0 p 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 #: '5� �` = �� &I,, Lot No. lb -OW Plan Name: 6�-' b� OW Block No. Project Name: DE IL D DE R TION F WORK: fla r New Electrical Meter Second Electrical Meter (Affidavit required) CONSTRUCTION INFORMATION: Additional work to be performed under this permit- check all that apply: _ Gas Tank Piping Shutters Windows/Doors Pond �- �MMechanical —Gas _ _ _ " Electric _ Plumbin _ Sprinklers _ Generator _ Roof Pitch J r� Total Sq. Ft of Construct 6 ��1�(] �` Sq. Ft. of First Floor: Cost of Construction:.5 c ©nf) Utilities: —Sewer _Septic Building Height: OWN ER/LESSEE: CONTRACTOR: Name Name: efr4 Add ress• c'- , r Company: r l'U City: State- i AddreG Zip Code: c G Fax: City: G. rr� State: Phone No. 7 7 - e Zip Code• G- Fax: E-Mail: Phone No V e Vo Fill in fee simple Title Holder on next page ( if different E-Mail from the Owner listed above) State or County License 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. f SUPPLEMENTAL CONSTRUCTION LIENLAW INFORMATION: DESIGNE NGINEE,�, _ Not Applicable MORTGAGE COMPANY: of Applicable Name:"6 -� Name: Addre U (% Address: City: /. tate: Cit State: Zip: • L Phone l 3 p: Phone: FEE SIMPLE TITLE HOLDER:- N pplicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: Cit City: Zip: Phone: Zi Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. 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 the jobtite before the first inspection. If you intend to obtain financing, consult with lender or an attorn a commencingwork or recording our Notice of Commencement. Sign ure of Owner/ —Lessee/Conlrractor s Ag for Owner STATE Of FLORIDA UNTY OF COSA_ Sworn to (or affirmed) and subscribed befo me of P sical Presence Online Notarization or this __4 day of by �eAll Name of person makinj statement. Personally Known OR ProdVO ication Type of Identification Pr ced ) (Signature of Notary Public- State of FkgAaWill Commi i/a. ELLEN VAUGH�ea') _* *_ is = Commission # GG 270079 i9�FOFF�oa?;.` My Commission Expires ` October 22. 2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev