HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
§ F2 17
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L
D'i R, Building Permit Application
Planning and Development services
Building and Code Regulation Division Commercial
2300 Virginia Avenue,Fort Pierce FL 34982 Residential
Phone: (772)462-1553 Fax: (772)462-1578
PERM"'T APPLICATION FOR: 'e
PRO"`_"'S'E_D IMPROVEMENT LOCATI
Address:
Prooert\j Tax ID#: 2A EL 9 le
-7 Lot No.
Site Plan Name:— C�e- k-A s-
C lock No.
EL ,3 -IV I
Project- i &—j, e: A-1,.A_1 s'; cj 0 f
I
DETAi,,f_'_L`D DESCRIPTION OF WORK:
A-7
New Liecici,lical Meter
Second Electrical Meter (Affidavit required)
Co
CTION INFORM XTkQW,-
Additional wo rk to be performed under this permit—check all that apply:
—Mechanical —Gas Tank —Gas Piping Shutters Windows/Doors Pond
Z Plumbing —Sprinklers Generator Roof
Pitch
i' Total Sq. Ft of Construction:
Sq. Ft.of First Floor:
Cost 09
Construction:$ a. Utilities: Sewer Septic Building Height:
SSEE,
CLJ S S E E:
CONTRACTOR:
TName:
d
2S G-' n
C
A Fdd r S s: __2 S_
Company:
ompany:
City: 4—3-f— (_L'� State:
Address: CoYl j r -S4e I(
Fax: City:
o State
Phones (®Zip Code: 315,Pj� Fax: -7 Z
E-M Q-!'! Phone No _2 2 -1 J'J
FER1 F;, iniple Title Holder on next page(if different
E-Mail L-C1 v
listed above)
State or County License L—C j L1,
liva"—ua �a action-
is 2500 or more,a RECORDED Notice of Commencement is required.
if, -"'q' c is$7,500 or more,a RECORDED Notice of Commencement is required.
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VB..5e; '-R ENGINE'E `Not Applicable MORTGAGE COMPANY: 4 Not Applicable
Nair:=:_ Name:
Add reS s: Address:
City:. State: City: State:
Zip: Phone Zip: Phone:
FEE Sr:;`P§E TITLE HOLDER: !Not Applicable BONDING COMPANY: _ Not Applicable
Narne: Name:
AcldresS: Address:
City:_ City:
p Zip: Phone: Zip: Phone:
i
O z+u'N `_'CONTRACTOR AFFIIDVIT:Application is hereby made to obtain a permit to do the work and installation as'indicated.
I certify.not 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 i conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structur:_Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consiceration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
in acccr_. ?cs with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
aThe fchovuing building permit applications are exempt from undergoing a full concurrency review:room additions,
l accessc:y_',ructures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
TO OWNER:Your failure to Record a Notice of Commencement may result in paying twice for
i icr,_ ernents to your property.A Notice of Commencement must be recorded in the public records of St.
L u `= County and posted on the jobsite before the first inspection. If you intend to obtain financing,consult
iv! 'ender or an attorne before commence work or recording our Notice of Commencement.
Sigr=t.:e f Ov✓ er/Lessee/Contractor as Agent for Owner
g S T-`- -"L0RIDA
Pt
S :rom or affirme and sub ribed before me of ^Physical Presence or Online Notarization
thi_ -y of L 2+3� by
\z:r. 5 making stat ent.
R
oVv' oR Produced Identification
y ication Produced
L�cz V__t11
�-1s o;.votary Public-" ate of Florida) "i° '°� "•"""""""" �'"
is ,-,�:.
CYNTHIAD.TUNING
(Seal) * ' ;; MY COMMISSION#GG 367784
"3- $ EXFIREs:September 23,2023
„d f` Bonded Thtu Notary Public Underwriters
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FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNT ER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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