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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO-BE ACCEPTED a\� ri Date: 3 a Permit Number: 0<01'1 i�llo L5CIJL� N `5 �� RECEIVE VED r Building Permit Application , Planning-and Development Services ` St.Lucie Co PenrA,$ir�q _ =Qa�; �� .Building and Code Regulation Division ��. Commercial Residentialy. 2300 Virginia Avenue,Fort Pierce�FL 34982 Phone: (772)462-1553 Fax: (,772)46 1578 u,„CB^DG Funding PERMIT APPLICATION PROPOSED IMPROVEMENT LOCATION: : . —Cd Address: © .a, Property Tax ID#; 7-4 Z7 (ag2� C7-\E5� ®77 Lot No. Site Plan'Nam e: \ ��` � Block No. 't z - µ7 ProjectWame: DETAILED DESCRIPTION OF WORK: n« c�71{p'0 New Electrical Meter Second Electrical Meter (Affidavit req red) I - CONSTRUCTION INFORMATION:. '=" Additional work to be performed under this permit—check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Pond T _Electric _Plumbing _Sprinkl rs _Generator Roof " Fitcho;,' .: t � Y Total Sq. Ft of Construction: Sq. Ft. of First Floor: �` Utilities: Sewer Septic Building Height: ?` Cost of Construction: $ bC�f7 _ — p g g OWNER/LESSEE: CONTRACTOR: Name Name: - Address: Company: �4 City: State:' - Address: Zip Code4��Z Fax: City. State: Phone No. —7—7 E- Zip Coder Fax: - Mail: Phone No .�'���` �l r-- sn3 t9"1 Fill in fee simple Title er on next' fiQe(if different E-Mail o d (� _ 1 . from the Owner listed above) State or County Licens�C�L:3� N ��__ tt= iI If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. Ifi If value of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION' DESIGNER/ENGINEER: Not Applicable MORTGAGE i;OMPANY: _Not Applicable Name: Name: _ 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 conflicts with any applicable Homeowners Association rules,bylaws or and c •:anants that may restrict or prohibit such ° structure. Please consult with your Homeowners Association and review your deed•or 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 attorney before commencing work or recording our Notice of Commencement. Signature of Owner/Lessee Contracto s Agent for Owner STATE OF FLORIDA COUNTY OF Sar. Sworn to(or affirmed)and subscribed before me of Physical Presence:or Online Notarization this'N day of cxy 2AA by zi Name of person aking statem nt. Personally Known OR Produced.identification Type of Identification Produced '�- i (Signature of Notary Pu ic-State of I OWN WEANNAGIVENS *AY'AB"%: Notary Public State of Florida ^` Commission N&A� 035 086359 qc•�'•w� Commission�HH Z025 � o�.' MY Comm. , a Expires Jan 28 .F�,._' National Notry Bonded through _ REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TORTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW 'REVIEW DATE RECEIVED DATE COMPLETED Rev �11 -