HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED. FOR APPLICATION TO BE ACCEPTED //�•� /` �j
Date: •/7Of' • Permit Number:'U��
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Building Permit. Application SUN 1720
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Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address:- 5�1i /�mtLv
22 �
Property Tax ID #: 2,33" 23 7 -
Site Plan Name:
Project Name:
New Electrical Meter
Second Electrical Meter
St LM,
Residential
4r--&
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 Plum77bing' _ Sprinklers • _ Generator _ Roof Pitch
Total Sq. Ft of Construction. J 21 Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: —Sewer _Septic Building Height:
Name
Address:�i
City: �� 1;e'C' State:
Zip Code;"
Phone No... ..�:.3,��.._��,•.....-...
E-Mail:CNVwnnnli-CC L4 cAr m -C^ le 5 LA 6w
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name:
ff�� PIT� Cr4L�s
Company:
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Address:
4436s 64'7-0, ;� "-
City: State: ��—
Zip Code:
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ghone No
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E-Mail
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State or County License
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to.obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association.rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida 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 attornev before commencihk work or recording your Notice of Commencement:
Signature of Owner/ Lessee/Contractor as Agent for Owner
Sign re of Contractor/License Hol er
STATE OF FLORIDA
ATE OF FLORIDA
COUNTY OF
COUNTY OF'
Sworn to (or affirmed) and subscribed before me of
Swor o (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Ph sical Pre n or Online Not riza
this day of 12020 by
this day of ?,BBC) by
Name of person making statement.
Name of pers makingststatement.
^Produced
Personally Known OR Produced Identification
Personally Known OR Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida)
(Signature
y.P �,_,rYB
No. (Seal)
Commission:..MY
AUDRUMPHREYCommission
N##GAW)7
;�,F....o�.•. EXPIRES: March 6, 2023
REVIEWS
FRONT
ZONING ''SUPERVISOR
PLANS
MANGROVE
VEGETATION
SEATURTLE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE `
COMPLETED
Rev. 5/6/20