HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: � � � U\Yd�� J 0 ?30xPermit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: SI0D
Residential ✓
Address: Lnl[)� /,���f'i' �►PrCPG'1�\y�G,\,�,.
Property Tax ID #: �l 2����7 n O'[P X )�C� _ Lot No.
Site Plan Name: Block No.
Project Name:
New Electrical Meter. Second Electrical Meter �ATTIaavii requireal
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors _ Pond
Electric _ Plumbing —.Sprinklers —Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ ?,nC)(1) Utilities: —Sewer _Septic Building Height:
Name'�>_C_
Address:��
City:
Zip Code: 1 Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
'Nam'e:
Company: C C,\]c
Address:�j�L,'`� �ivc
-4
'City:�C,C it State:
Zip Code: 3Z�Cp Fax:
Phone No727-- 0 6_,3-3 Y :5 q
E-Mail ct.Cbrvi_
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.
so
MORTGAGE COMPANY: Not Applicable
Name:
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
Address:
City:
Zip: Phone
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY: Not Applicable
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 onthggJobsite before the first inspection If you intend to obtain financing, consult
with lender A an attc/rneylyffre commencing'work or recording your Notice_o.f Commencement.
Signature offO%Nner/ Less ton or as Agent
STATE OF FLORIDA
COUNTY OF ',A-.
Sworn to (or affirmed) and subscribed be me of ✓Physical Presence or
this \_ day of S pk-Cr\ l Xr- , 20ZJ by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification Produced �D.I— .
(Sign e of Notary Public- State of Florida )
...... •. CRISIINA ONTNEROS - .
Commission No. (Seal) MY MY COMMISSION#HH103529
EXPIRES: March
o,
�•'Fp:�;°Q,• Bonded ThruNotaryPublic Undetwrftero ,
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED