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 Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: �~
PROPOSED IMPROVEMENT LOCATION.- //
Address: ram( r : v
Property Tax ID #: 3 Z ( `p �C> L - �1f Cep o oc>- Lot No.
Site Plan Name:--'_� I�I,c_ I �(.I�r,L or \Block No.
Project Name: C. - S
DETAILED DESCRIPTION OF WORK: ,
1 e s l s Li } .✓l S I-e-C n e �-'t K r"� r1 nE,6 tJ �1®
s 1 +z R•. 12 00 �-F.�wiyJ �T_� Sc 4c�i �s i
New Electrical Meter Second Electrical Meter (Affidavit required)
( CONS" RUCTION INFORMATION: �
Additions; work to be performed under this permit - check all that apply:
_Mechanical — Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
1� d_lectric _ Plumbing — Sprinklers — Generator Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of Construction: $ r,Z,i3 Utilities: _ Sewer _ Septic
Building Height:
Pond
Pitch
OWE --` 'LESSEE:
CONTRACTOR:
Name- Gc e t
Name:
Address:�: z,D V-S-
Com an `�e^� �l i>nr
p Y: a
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City: State: -EL
Zip C� `Z G. d' Fax:
_
Phone Nlo. �f r�� - -Z-
Address:l �-( U,
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y
City:.- 9� C- S% State:��--
Zip Code: 3 11� If1� Fax??
Phone No
E-Mail:_
Fill infa�; simple Title Holder on next page ( if different
frorn t : - 'Owner listed above)
E-Mail (L/1 -rvC
State or C@ my License Cr D 33 / 1
vaucu 4ulizLI M IL)II i!) cwv or more, a KtLUKUtu Notice oT commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
M E K7LCOW STf �11Cil�i L G Ar
�etlENGINEER:
Not Applicable
IN
— MORTGAGE COMPANY: Not Applicable
AddreSS:
Name: —
City:
Address:
-
Liv: _
P� tune
State: City:
State:
i
Zip: Phone:
TITLE HOLDER:
Name:
_ Not Applicable BONDING COMPANY: Not Applicable
Addres :
Name:
Cit`r:
Address:
Zip: Phone:
City:
Zip: _ Phone:
CONTRACTOR AFEIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I cer-df; ^at no work or installation has commenced prior to the issuance of a permit.
St.
is ;n conflict County
with any representation
iHomaOrwners Association permit will
or andpcovenants that build
or pr prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In cons;dei-a Lion of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accarc.a ce with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The f"ollcofi:-Ig building permit applications are exempt from undergoing a full concurrency review: room additions,
accessc: uctures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
7-0 OWIM ER: 'dour failure to Record a Notice of Commencement may result in paying twice for
irnr.-c�vements to your property. A Notice of Commencement must be recorded in the public records of St.
Lu = ,`--O my and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
`lei: -Index or an attorney before commencing work or recording our Notice of CommPnrPr„Pnt
Sigr =t!_; f Ovd er/ Lessee/Contractor as AgentOwner
S`•:orn !or affirmed and sub ribed before me of Physical Presence or
thi;, ray o�f /�' 20_ by _
Via:;:_ _. � .>ah making stat ent.
Pers r :::. .Cnovvn OR Produced Identification
_y_ if. cation -Prod uced
(r o; Notary Publi
REVS%
DATE
RECEIV.,:.
COAL]? =
Rev!
, — war
CYNTHIAD. TUNING
(Seal) L44
MYCOMMISSIDN # GG 367784
��• EXPIRES: September 23, 2023
T4, Bonded Thru Notary Public underwriters
online No
tarization
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
`D