HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Commercial
PROPOSED IMPROVEMENT LOCATION:
Residential t<
Address: S 1'306 � s '4eNEA"
Property Tax ID #: 4Sb - bd1- ol7w
Site Plan Name:
Lot No.
Block No.
Project Name; T-vvK F
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter
(Affidavit required)
� , NSTRUCTI.ON JN.F'OR' ATI°ON
Additional work to be performed under this permit- check all that apply:
,Mechanical — Gas Tank Gas Piping
Shutters K Windows/Doors Pond
Electric _ Plumbing _ Sprinklers
_ Generator Roof Pitch
Total Sq. Ft of Construction: ti.ft2 3
Sq. Ft. of First Floor:
Cost of Construction: $ s 000 Utilities: `Sewer _Septic Building Height:
OWNER/LESSEE:.
CONTRACTOR:
Name T,)A,! F � +ixc_
Name: wiz
Address: �'SS0 S pLa a t r t3D b
Company:
City: T th'`'S ev^-'gsp� State; FL
tL
Address: tu # ,
Zip Code: 3`tS Fax:
City: Lkz r State:F(-
Phone No.
Zip Code: 33411 Fax:
E-Mail:
Phone No a—(foo -Tsa{
Fill in fee simple Title Holder on next page [ if different
E-Mail
from the Owner listed above)
s C
State or County License Gb(--►.raks"}y
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.
00
P ,MENTAL Ct N .Tfi4JCG1OI LIEN LAW
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
I Fa.RMAT1'ON o
F
AGE COMPANY: Not Applicable
:
State:
Zip: Phone:
FAddress:
DING COMPANY: ^Not Applicable
e:
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 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 jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or recording our Notice of Commencement.
7G
Signatur Owne Lessee/Contra as Agent for Owner
STATE OF FLORIDA
COUNTY OF 1�aE- j—
Sworn to (or affirmed) and subscribed before me of k Physical Presence or Online Notarization
this —(+— day of Sr 20 Zt by
Name of person making statement.
Personally Known X OR Produced Identification
Type of Identification Produced
of
Public- State of Florida )
Commission No. b I±fy�_ (Seal)
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
RNotary Public State of FkgWa
Michael .fames w is
My Commission GG B70iS24
Expires U311e=4
SUPERVISOR - PLANS VEGETATION � SERA TURTLE I MANROVE
REVIEW REVIEW REVIEW