HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAli APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I
Date: Permit Numb
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C-)), rf DO 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
PROPOSED IMPROVEMENT LOCATION:
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Property Tax ID #: 3�2Al2 oc)oi- Lot No.
Site Plan Name: Block No.
Project Name: nhand le'r QAJ2-0C--:1--
[ DETAILED DESCRIPTION OF WORK:
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New Electrical Meter Electrical Meter
CONSTRUCTION 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 4Z Roof Pitch
Total Sq. Ft of Construction: - Sq. Ft. of First Floor-,
Cost of Construction: 00 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name- E --v C zlr'ci —lC-r
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Name: Camijg2n ;�)ec
AkAddress:0002Cb!&�
company: oa
City. ..-a Rc�rL"- '� State:c2
Address: 1S. Nlej90rUw (A�e
Zip Code: 5T %,S f 2'2- Fax:
City: pn7L®
Phone No-112U21-U2L&
-State:
Zip Code: 34 95L - Fax:
E-mail:
Phone No-4-2 (021 LeVP8
Fill in fee simple Title Holder on next page (if different
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from the Owner listed above)
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State or County License
®S VdIuv V1 uunurucxion is zziuu or more, a mtcumutu Notice of Commencement is required.
If value of H"C is $7,500 or more, a RECORDED Notice of Commencement is required.
Name,
Addre=---
City: .— State
ZIP'___,_ Phone
FEE SIMPLE THE 56LDER, Not App Ffc-a--bWe—
Name:
ZIP:
MORTGAGE COMPANY: Not Applicable
Name-
Address -
City, 5it—li—
zip-, Phone,
c
Name:— Not�p`plia —ble
Address.,
City.
Zip-, --- Phone,—
OMMER/ CONTRACTOR AFFIDVIT: Application is her--bY made to obtain & Permit to do the work and install -Aloe —asindicated,
1 Ce'rt"irthat W WO&Df installation has commenced prior to the issuance of a permtt. '
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is it). conflict with any applicable Home Owners Association rules, bylaws or ancoveriants that may restrict or prohibit such
structure, Please, consult with your Kome Owners Association and review your deed for any restrictions which may apply
in consideration of fie granting of this requested permit, I do hereby agree that I will, in ail resPectz;, perform the worl(
it) accOf4ance with the approved plans, the Florida Building Codes and 5t. Luf le CountyAmendments.
The following building permit applications are exempt from undergoing a full, concurrenty review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rOOnTs and accessory uses to another non-residential use
WARNING TO OWNER.- Your llare to Record a Notice of commer1cement rn ..IV result in paylilp
Improvements twice. for
to your Property, A Notice of Commencement must be recorded in the pubf ic records of -st,
Lucie County and posted on the jobsfte before the f1mt inspection, If you Intend to obtain financfng, consult
with lender or an attorrimv -A,
:Rstwlult cxc %,wnerj Lesseelcontractor as Agent for Owner
COUNTY FLO RJ DA
COUNTY
Sworn to (or affirmed) and subscr, before me of
a! Presince or o
d none Notarization
il'-F,'Fdl;�Nwfuua6202V by
Name of person making-statim—errt
' t 'novvn o t produced Identification
4 _r n
of 1=ri fication
,A9rTaTUr0 Or Lontractor/LfConse Holder
5-1 ATE OFFLOIRIDDAI�
4TY OF COUN
wo for affirmed) and subscribed before me of
al Pres lln,- Notiirizatfon
this -y of 'se co or 202q by
of person making state
7 ' " OR Produced identification
of 1deS`fication /A% A
State of Florida )
Public State of Florida ( I I '1o17i
PLANS
REVIEW