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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION i All APPLICABLE INFO MUST BE COMPLET D FOR APPLICATION TO BE ACCEPTED NN�22 _Date: Permit Number: • �YJ� -`v Uo L�Ll�L1L5 RECEIVED Building Permit Application A UG Planning andl Development Services st.Lucie Coun j rm Building and,Code Regulation Division Commercial Residential Pe ittl 2300 VirginialAvenue,Fort Pierce FL 34982 Phone: (7721)462-1553 Fax: (772)462-1 78 CBDG Funding I PERMIT APPLICATION FOR: PROP®E'� IMPR�O�UEME`NT LOC TIO`N: ? gym_� " � Address: Property Tax y o 0.2 Q - cod - 7 Lot No. Site Plan Name: Q Block No. 7� Project Name: I DETAILS® DESCRIPTI©N SA V S 5'i4 D o/. b :4 ' Po s.l' New Electricall Meter Second lectrical Meter (Affidavit required) CO�NS�T[R�U.CyT11,QiN LNF©TRMA�iTil� 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 /%A-1` Pitch Total Sq. Ft of Construction: I Sq. Ft. of First Floor: Cost of Construction: $ /0 �� ) / Utilities: Sewer Septic Building Height: O NER/I.ES-SEE: Comm KN ! s Name I Name: o- P-A Address: 11 1 1 ir 9R ! ` Company: City: State�/1� Address: SG�. .',�� n Zip Coder �'(�1 Fax: n �� City:f DK X State:�t! Phone No. ?i7;2, - a. O E- Zi Mail: ll C� a-S j p Code: �f S 3 Fax: • Phone No - ol./pl — S'-J Fill in fee simple Title Holder on next page if different E-Mail ten :!V 0 @ n7A C-� from the Owner listed above) State or County License ecc (g 3 /3 If value of construction is 2500 or more,a RECd DED Notice of Commencement is required. If value of HAVC is$7,500 or more,a RECORDE Notice of Commencement is required. i SU?[ M ENTAL CONST' MMCO M 1102% LAW INFORMATION: DESIGNER/ENGINEER: _ Nit Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: I Itate: City: State: Zip: Phone Zip: Phone• I I FEE SIMPLE TITLE HOLDER _N� A plicable BONDING COMPANY: _ t Applicable Name: Name: Address: I ' Address: City: City: Zip: Phone: 'I Zip: Phone: I a OWNER/CONTRACTOR AFFIDVIT:Apl lication is hereby made to obtain a permit to do the work and installation as indicated. I certify that ni work or installation has com enced prior to the issuance of a permit. St. Lucie County makes no representation than is granting a permit will authorize the permit holder to build the subject structure which conflicts with any applicable Homeowr) rs Association rules, bylaws or and covenants that may restrict or prohibit such structure. Pled dIse consult with your Homeowri rs Association and review your deed for any restrictions which may apply. In consideration of the granting of this reque ted permit, I do hereby agree that I will,in all respects,perform the work in accordance(with the approved plans,the FII rida 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:Iecord a Notice of Commencement may result in paying twice for imaen nts to your property. Notice of Commencement must be recorded in the public records of t. Luy and p sted on the jo site before the first inspection. If you intend to obtain financing, consult w' or aniattornev before ornmencing work or recording our Notice of Commencement.' II Signature f i caner/ essee/Contractor as A ent for Owner STATE OF FLORIDA COUNTY OF S tkx-.'0-- Sworn to r affirmed and subscribed befor me of Physical Presence or Online Notarization this�a lay of 20 Z[ by Ro Fk AOM-tp, Name of person making statement. II Personally Known OR Produced Identification Type'of Identification Produced (Signature of Notary Public-S to of Floridar�, L/ Exp�ims Commission No. (Seal) ublic State of Florida G Reidy mission GG 347651 0 6/2312 22 3. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE DATE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW I I RECEIVED DATE COMPLETED. Rev