Loading...
HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: I k1 I Permit Number: LL `R Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial k Residential 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding PERMIT APPLICATION FOR: PROPOSED IMPROVEMENT LOCATION: Address: ©3��� Property Tax ID #: ^ ' 1A - CkO l2 - 000 ' �o Lot No. Site Plan Name: CULb Block No. Project Name: - DETAILED DESCRIPTION OF WORK: 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 Electric Plumbing Gas Piping _ Shutters Windows/Doors _ Sprinklers _ Generator T Roof Total Sq. Ft of Construction: _ %BCD _�f Cost of Construction: $ 0o_ Sq. Ft. of First Floor: Utilities: —Sewer —Septic Building Height: Pond Pitch OWNER/LESSEE: CONTRACTOR: Name A.V Im Name: -ee1 cr���'i Address: \O lea 30 Company: 9 a (e- City: ens State: Address: ►A Sk A_ Zip Code: 'NP),51 Fax: City: State: Phone No. -'- E- Zip Code: WcA 4- Fax: -I - le h - 0217 Mail: Phone No 11 -),' U A) ' 00� Fill in fee simple Title Holder on next page (if different E-Mail \",eev4c P Q,p ew -1 A ?A Ivy-S. LA+'i from the Owner listed above) State or County License L Ls 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: _,Y,_ Not Applicable Name: _ Address: City: Zip: Phone State: FEE SIMPLE TITLE HOLDER: _G Not Applicable Name: Address: City: Zip: Phone: MORTGAGE COMPANY: Name: Address: Citv: Zip: Phone: BONDING COMPANY: Name: Address: City: Zip: Phone: Not Applicable State: of Applicable 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 covenants that may restrict or prohibit such structure. Please consult with your Homeowners 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 commencing work or recording your Notice of Commencement. Signature of Owner/ Lessee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF + Lu GI C Sworn t (or affir ed and subscribed before me of ]� Physical Presence or Online Notarization ] 1� this ay o :4— 20 �l by .0Ae.>r I nc, L a Dety� _L P od on of person making statement. Personally Known )i. Type of Identification Pi OR Produced Identification of Notary Public- State of Florida) Commission No.ffit1\1A601(Seal) REVIEWS I FRONT ZONING COUNTER REVIEW DATE RECEIVED DATE COMPLETED •, smoy N. FREUDENT1iAl. Commission # GG 16VA Expires December 19, 2021 BrK�ded TM v Tom] Fain kisuranca Rdo-W-7018 SUPERVISOR I PLANS VEGETATION SEA TURTLE I MANGROVE REVIEW REVIEW REVIEW REVIEW ` REVIEW