HomeMy WebLinkAboutBuilding Permit App - goodner All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
COUNTY
,
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 I`OR:
PROPOSED IMPROVEMENTLOCATION:
Address: ( /► 6- i Cr C C
Property Tax ID##: 3 q, / �` '�7J' ," 7��- J Lot No.--
Site Flan Name: Block No,
Project Name: �c clt C1L��i.J2 -2 (
i�l~TAILED DESCRIPTION OF WORK
/Z . :A e,f Ors-J 1 e1 �( IV i 4 6 Cz� _
New Electrical Meter Second Electrical Meter__.._ -
0NSTR TON 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:
a�
Cost of Construction: $ Jc , C Utilities: �Sewer �Septic Building Height: _-
OWNERAESSEE. ' 1 CONTRACTOR:
Name AJ�a✓^, 43. . 'fit c j°�- ' fume: �� �G C /e fig
Address; a 30 j 6r�✓�X Ct�t L b�LIV Company: Gt "16 Gt� i�-'� o ��P�• l£
City: rL ° 1,9
l c/-6 State:EL Address 37 S 141�k ,i
Zip Code: ,?'07 5r/ Fax: City:. Stater
Phone No... % ,�' Zip Code: 3`� `�� Fax: A/
-�vti,
E-Mail: �t ��� l Phone No 5� 3 ��r
I�/iG r
Fill in fee simple Title Hal er can next pale(if different E-Mail��� ¢� ,�'va �. I Co I,,
from the Owner Listed above) State or County License C,A2�//
If value of constnactian is 2500 or mare,a RECOR.DELD Notice of Commencement is required.
If value of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNEE{/ENGINEER: Not Applicable MO
RTda"AGE COMPANY: Not Applicable
Name: Name:
Address: Address:
i City: State: City: State
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: —Not Applicable
Name: Name:_ i
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 and covenants that may restrict or prohibit such
structure.Please consult with your Horne 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 l 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:rooms 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 jobsite 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 Signature of Contractor/License Holder
STATE OF FLORIDA STAVE OF FLORIDA
COUNTY OF �
.)-A"- i ;C
i. i COUNTY OF ,�e'''�ti. ei't C
Sworn to{ar affirmed)and subscribed before me of i Sv errs to(sir affirmed)and subscribed before me of
Physical Presence or Online Notarization ail Physical Presence or Online Notarization
this : clay of � C» 202A try this_ .a day of i ., _ 202+6 by
? cok C
Name of person making statement. Name of person making statement,
l
Personally Known V/ OR Produced Identification ___�_ Personally Known /OR Produced identification.-
Type _
Type of identification Type of identification
Produced_ Produced .
04
`_ of Flonda
(Signal re of Notary Public- �� Traci V52!/06110!
{ +nature sa Notary Public-State for a,
f3Q /, '1 My Com 93777
Commission No, i wyi2,= G rxiission N4 ILA/ 1� �zrxr•a
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.