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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: "l - ) Permit Number: SV LUGML ..,. ° n L� Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential X 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: PROPOSED IMPROVEMENT LOCATION: Address: 52(a0 Lycq I -Y-or-,r Property Tax ID #: Ig - 6 - Lot No. Site Plan Name:-AA4 d f I Block No. Project Name: --H86-e C)�� DETAILED DESCRIPTION OF WORK: e � 'I n r;r � j- ` �p 9a © V I`C� , E� New Electrical Meter Second Electrical Meter (Affidavit required) CONSTRUCTION INFORMATION: Additional work to be performed under this permit -check all that apply: Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond XE _ctric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ .3, aao' 1-4-- Utilities: —Sewer _ Septic Building Height: OWNERAESSEE: CONTRACTOR: Name MOL Name: Address: Company: City:'�r0►�'t-f State: k_ Address: /� Zip Code: Fax: �v' City: SA_ ' C__. State: F(I Phone No. 37 RnZip Code: Fax: E-Mail u) %0 (N Phone No 3 Fill in fee simple Title Holder on next pa`g ( if different E-Mail �(ar(Y1 y-i-lQr-,(�('p eCfl C r �(j��nryt from the Owner listed above) State or County Licensed,_ 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. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable Name: MORTGAGE COMPANY: Not Applicable Name: Address: _ Address: City: State: Zip: _ Phone City: _State: Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable Name: BONDING COMPANY: Not Applicable Name: Address: Address: City: City: Zip: Phone: Zip: Phone: UwrvtK/ LUIM I KAL I UK AhtIUVIT: 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 before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencine work or recording our Notice of Commencement ractor as Agent for Owner Signature of OLIDA STATE OF FL COUNTY OF Swornto (or affirmed) and subscribed before me of �PhysicalPresence or Online Notarization this _ay of 20CPA by Name of person making statement. Personally Kn OR Produced Identification Typ dentification Pro uced (Signature of Notary Public- State of Florida) CommissionNo. (Seal) — — — — — — _� Notary Public State of S�aYPum•., KONNI LENAE DEW]22,5. '�y"g4r Commission # HH 16 My Comm. Expires Dec Borded through National Not REVIEWS FRONT COUNTER ZONING REVIEW SUPERVISOR REVIEW PLANS REVIEW VEGETATION REVIEW SEA TURTLE REVIEW MANGROVE REVIEW DATE RECEIVED DATE COMPLETED P\/