HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: q ( ad Permit Number:
Building Permit Application
PfonMng and Mwopnient Sen4ces
Suflding and Code Regufatfon Dfftron
230D VfrgkdaAvenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial
PERMIT APPLICATION FOR: 1)ogti
PROPOSED IMPROVEMENT LOCATION:
Address:
Property Tax ID;
Site Plan Name:
Project Name: __LJ�aS
DETAILED DESCRIPTION OF WORK:
alai S
Residential
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Lot No.
Block No.
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: n Sq. Ft. of First Floor:
Cost of Construction: $ ``
1_ 1 �c ] - • 0 Utilities: —Sewer _ Septic Building Height: _
OWNER/LESSEE:
City:
Zip Code: Fax:
Phone No. -171- ?10— -1
City: LkA W& State._
Zip Code: /� Fax:
l Phone Noll1 T �- (o 9-G-7
Fill in fee simple Title Holder on next page (if differWkT'*i E-Mail
from the Owner listed above), 1 State or County
H value of cmutruction is 2900 or mom a RECORDED Nofe of Commencement is required.
ff value of HAVC is $7,540 or more, a RECORDED Notice of Commencenront Is required.
SUPPLEMENTAL CONSTRUCTION UEN LAW INFORMATION:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
ZIP: . Phone:
----
_Not Applicable
Name:
Laty:Addre
p: Phone: _ _� ZIP: Phone: -
OWNER/ CONTRACTOR AFFiDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
1 certify that no work or installation has commenced prior to the issuance of a permit
Not Applicable BONDING COMPANY:
Name:
Address:
UMIU M/15lYGIMEER: _ Not Applicable
Name:
Address;
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
e Cou fllet�wtth ae A�tpr Ikea dH�omthat
tO�wn�ers ciationit v�ill a cri=e the it holder to build the Subject structure
wht Is in Y PP rotes, am or�covena%that may restrict or prphibit such
structure. Pleaease consult with your Home Owners Association and review your de any restrictions which may apply
in consideration of the granting of this requested permit, I do hereby agree that 1 will, in ail respects, perform the work
in accordance with the approved plans, the Florlds 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 recordin gy
our Notice of Comm cement.
P A:CKELL R SPARKS
`--,Notary Public State of Florida
atltre of i Qne�I t fteee lC . r � A. 4 e_. n . '�C A °. use rnmthissi0n n C i 222291
- •/ ....rr., ...Z-iisi .fir. iras 5• o i�,
STATE OF FLORIDA
COUNTY OF e1UP- '
NyLomm. P
" Bonded th,lugh 0:!t:ona1 Notate
Sworn to (or affid) and subscribed before me of '� Physical Presence or Online Notarization
rm
thisLL day of r 20jj by
Name of person making statement.
Personally Known OR Produced identification
Type of Identification Produced _ —_ .
(5lgnature of Notary Public- State of Florida)
Commission No. • (Seal)
REVIEWS I FRONT ZONING
COUNTER REVIEW
DATE
' COMPLETED
ev 721
SUPERVISOR f PLANS VEGETATION
REVIEW I REVIEW REVIEW