HomeMy WebLinkAboutBuilding Permit ApplicationAIIAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date 7'-z- 2t /OCoft # PermitNumber
717-7)-7-lao) i,i itli- '%
t, rl i ,. -,-\ ", , $'* L: Ll-r.\'l- -l
Building Permit Application
Planning and Develapment Services
Building and Code Regulation Divisian
23AA Virginia Avenue, Fort Pierce FL 34982
Phone: (772j 462-1553 Fax: (712) 462-1578
Commercial Residential
CBDG Funding
PERMIT APPLICATION FOR: Drro /, y';o,t
PROPOSED I MPROVEM ENT LOCATION :
Address 2ot 8 .r/c///tt B/r/ Tcnyt, Oeoch , Ft. 3/7f7
Property raxrD#: /fO2- fot- OO2 | - OOO' /tatNa.2o/2
site Ptan Name: ftre ///e r -Tf/qn/Block No
Proj ect Name: 2O t Z
Orvq)room.
Second Electrical Meter (Affidavit required)
CONSTRUCTION I NFORMATION
Additional work to be performed under this permit - check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Piumbing _ Sprinklers _ Generator
_ Windows/Doors
Roof
Pond
Pitch
Total Sq. Ft of Construction 7/r/Sq
Utilities:
Ft. of First floor: --7/j
Cost of Construction: $/9o0.^,fr"**r. - Septic tsuilding Height &+
lf value of construction is 2500 or more, a RECORDED Notice of Commencement is required
lf value of HAVC is 57,500 or more, a RECORDED t\otice of Commencement is required.
€m n
OWNER/LESSEE:CONTRACTOR
Name L.*
Address o/0 €
City:finfo', Dcoa4 Starc: Fl
Zip code: 3 47fZ Fax
Phone Na. 7 7 2-1Aa: UOl E
Mail:
Fill in fee simple Title Holder on next page (if different
from the 0wner listed above)
Name:ar,;tA
Company
Address:
(Ica/),
d// /t .f . Spcn ccr Sl,
City:-,JCa fen 6€q ch State: 4
Zip Code 3q7f7 Fax:7U-212"2tft
Phone N, 7 72 - 210-3 7f
r.-vait a./atn 5mi// i,tc €ya/oo -co.t
State or County License c9< /2 r/73/
,Y
New Electrical Meter
PhonZip:
Address:
City:
DESIGNE
Name:
MORTGAGE COMPANY:
Name:
ble
State:
Phone:
Address
City:
FEE SIMPLE TITLE HOLDER:
[\ame:
Not
Address:
City
zip:ne:
COMPANY:_Not Applicable
Phonezip:
City:
Name
Add ress
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 instailation has commenced prior to the issuance of a permit.
St. Lucie Countv makes no representation that is granting a permit will authorize the permit holder to build the subiect structure
which conflicts with anv applicable HomeownersAssocia-tioh rules. bvlaws or and covenants that mav restrict or nrbhibit such
structure. Please consult with your Horneowners Association and ieview your deed for any restrictions which may appiy.
ln consideration of the granting of this requested permit, I do hereby agree that lwill, in all respects, perform the worl<
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, swirnming pools, fences, wails, 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
be recorded in the
twice for
improvements to your prcperty, A Notice of Commencement must pu
in
blic records of St.
Lucie County and posted on the before the first inspection. lf you intend to obta financing, consult
with lender an atto mmenci work or recordin r Notice of Commencement.J)9{U t 94,,\
Signature of Owner/Agent for Owner
STATE OF
COUNW OF
Swoln to (or affirmed) and subscribed before me of
thisK{-\ day of Lpld , z&! nv
Ar,\rur. *r-o+l^
V/ Physical Presence or
-
Oniine Notarization
Name of person making statement.
Personally Known OR Produced ldentification U e 1
Type of tdentification produ r.a trl dZi OA \ J---
t'huo-,X,,, trh'ffi
{Signature of Nd{ary Puhlic- State of Florida)
Commission No.H*a*''ilgL (5eal)s,-.""'.j"
l,ffi&;
MARY LEE iUATTiS
Comnrission # HH 0894-oB
Expires March 6, 2025
Eoided Thru Budaet Notary Seryi€s
REVIEWS FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REV W
MANGRO\IE
REViEW
DATE
RECEIVED
DATE
COMPLETED
s u P P LE r\*ryTAL CO N STR U CT|O N Ll E N LAW r N FO R MAT| O N :
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