HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMP
Date
FOR APPLICATION TO BE.ACCEPTED,,
Permit Nu,Piber: I oli7 O�C.J
9U LUCIl �s
RECEIVED
u v r r JUN 0 2 2011
Building p p Permit A lication
Depe rtMenl
Fermirtin9
Planning and Development Services St.
'�ucte/County
Building and Code Regulation Division Commercial Residential [/
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
I PERMIT APPLICATION FOR:
y
PJ p-60WTaxID#: 'teal-(C'n- -61aq -cY—)0 Lot No.
Site Plan Name: Block No.t2
Project Name:
New Electrical Meter
Second Electrical Meter
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Co's f Construction: $ q -.<"o(�cS
Name
(Affidavit required)
_ Generator
Sq. Ft. of First Floor:
Windows/Doors Pond -
Roof ` Pitch
Utilities: _Sewer _.Septic -,Building Height:.
Address:�;t�rbe
City:
ZipCode:�4��(
, Fax: %2-._64(.�i9 82
Phone
E-Mail:.l�savwa�LiLiP.�i.[nc�c5�(���JVIc�,S
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Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name:
Company:
Address:
Citv:
Zip Code:
Phone No
E-Mail
State or County Lice
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.
Fax:
State:
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DESIGNER/ENGINEER: _Not
Applicable
MORTGAGE COMPANY:
Applicable
Name:
Name:
_Not
Address:
Address:
City: �
State:
City:
State:
Zip: - Phone
�
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not
Applicable
BONDING COMPANY:
Not Applicable.
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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 attorneybefore commencingwork or recordingour Notice of Commencement.
5/20/21
-
Signature of O er/ essee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OFC1.�
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of , 20_