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HomeMy WebLinkAboutBuilding Permit ApplicationAF(PLICABLE INFO MUST BE Date: FOR APPLICATION TO BE ACCEPTED ' Permit Number:] �� V� ✓ Z f;�G�ZVEO Building Permit Application 6110 Planning and Development Services ��Nepa�cne0r Building and Code Regulation Division Commercial Residential vr6%V.Xer-°U�ty 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: ki PROPOSED IMiPROUEMENT LOCATm: Address: bCB Property Tax ID #: i30 70 1 i 0007 Lot No. Site Plan Name: Block No. 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 ndows/Doors _ Pond V Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: �(� Sq. Ft. of First Floor: i Cost of Construction: $ %/, d 0 0 A Utilities: —Sewer —Septic Building Height: %Z OWNER/L CONTRACTOR: Name elo i e'L Name: Address: F�_o N v P Company: City: /—O -^ ,` eec_ State:%< Zip Code: Y,5119<—1 Fax: Phone No. % v2 S� 2-06 Address: City: State: Zip Code: Fax: Phone No E-Mail: vi e/ Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail 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. SUPPLCMENTAL C©NSTR,UCTICIN LIEN LAW IN 'O KO,&TI N: DESIGNER/ENGINEER: _ Not //Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: elrQLI,72�- OagC�Z&r City: r e Stater City: State: Zip: 22 nQt Phone -�----ram 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 fore the first inspection. If you intend to obtain financing, consult with lender oran attoAv be-JSre copiencing work or recording your Notice of Commencement. i Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF S-_ L oe COUNTY OF S Y6 to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of ✓✓ Physical Presence or Online Notarization Physical Presence or Online Notarization this _J_ day of 24 LI by this day of 21_ by Name of person making stateVent. Name of person making statement. Personally Known OR Produced Identification✓/ Personally Known OR Produced Identification Type of Identification Type of Identification Produced �� „"11fj' k, Produced i0 (Signature of Notary Public- Sta of Flo 'da) �'"'�""u, (Signature of Notary Public- State of Florida ) Commission No. (Seal 0 o, An 3 Commission No. Seal0 ( ) .o •� a REVIEWS FRONT ZONING 1� PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW MQM REVIEW REVIEW REVIEW REVIEW DATE N=• 0 "° 7) RECEIVED m ;`so DATE COMPLETED ev. 5/6/20