HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABV INF �^1MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 741P lot, I Permit Number:
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> Building Permit Application /
Planning and Development Services /
Building and Code Regulation Division Commercial Residentialy
2300 Virginia Avenue, Fart Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: AIC CAt�IE OUT / EME9,&ENC\%
I PROPOSED IMPROVEMENT LOCATION: I
Address: L-3 1 '1 l Z N L l �--1
Property Tax ID #: I 3()Cn - I I - 6001 — 600 Lot No.
Site Plan Name: /� n Block No.
Project Name: Mf-LLER I CSTDQ X-C
I DETAILED DESCRIPTION OF WORK: I
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Addition I 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:
Cost of Construction: $ 5050
(Affidavit required)
_ Generator
Sq. Ft. of First Floor:
Windows/Doors
Roof
Utilities: -Sewer _Septic Building Height:
Pond
Pitch
OWNER/LESSEE:
CONTRACTOR:
Name 49,1ST
SL C(L ff N
Name:
MARV,
Y-1 Vaias
Address: 7 STt4swvv-r
Company: L C
L
City: State: _rL
Zip Code: y 45 Fax:
Phone No 315 480-5`t 00 E-
Addres : �Sq
R L
City:
Zip Code: 33 Ci i
Phone No 6)
c-M C—Ack State: EL
Fax:
433 -J 19
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail DP r wjrt SC° (1-r+ 14c- • Com
State or County License LAC C
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.
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
Not Applicable
MORTGAGE COMPANY: ✓Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: ✓Not Applicable
Name:
Address:
City: _
Zip:
UW NtK/ WN I KA(.I UK A"IUVIT: 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 conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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, wag, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to cord a Notice of Commencement may result in paying twice for
improvements to your property. Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the ' P.
before the first inspection. If you intend to obtain financing, consult
with lender or an attorney be re commencine'work or recording vni4 Nnrira of rnmmanr•amanr
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORI nn
--�,,
COUNTY OFLM L
Sworn to for affirmed) and subscribed before me of \1C Physical Presence or Online Notarization
_
this ay of SE PT9M13EQ, 20a by
MARK A if SSE
Name of person making statement.
Personally Known —)C— OR Produced Identification
Typ of Identification Produced
( ignature of Notary Public- State of Florida)
CC. faiwv
Commission No. s3 4912 (Seal) } pAYP 4� N°tary P S is stare of P90 ca
H�ialisa Waiting
+. � My ;:ommisaon GG 33S912
��tidF Expires 05/2912023
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