HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAIIAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
o,tu, 7 -8 - Ll / o ,o te # Permit Number:
Planning and Develapment Services
Building and Code Regulation Divisian
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 452-1578
Com mercia I Residential
PERM tT AppLtCATtON rAR: Qe.,to l^ h.on
PROPOSED I M PROVEM ENT LOCATION :
Address: 10701 < Ce*r, 0..#/?! Jen {c't O*ol , FL' 3 /7f7
Property Tax lD #
Site Plan Name:
/- 80 ool/- oo0-LotNa.lf -1fu
Wn/rrc Tltna Block No
Project Name 6
Om t le ,f rto,l,'€/A14
{/on,J^rO0/4
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION I NFORMATION :
Additional work to be performed under this permit - check all that apply:
_Mechanical __ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors Pond
Pitch_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof
Total Sq. Ft of Construction:guL Sq. Ft. of First Floor:,/2
Cost of Construction: $ _1flfu,rt Utilities:t'S"*", - Septic Building Height: Yft
lf value of construction is 2500 or more, a RECORDED Notice of Commencement is required
lf value of HAVC is 57,500 or more, a RECORDED Notice of Commencement is required.
CIWNER/LESSEE:CONTRACTOR:
Name
E/ 5.V rA fcr
City:rf /-o, dc"
Zipcode: ???/L- floz r""
Phone No.
Mail:
State:f1.,
E
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
City:Ten rtn Bu,o state'FZ.
Zip Code Lfry{] rax:77) -272-2/ rr
Name:
Company
Address:oncc. 5/.
/,
Phone r't, 772-2/0:3 7/{ -E-Mail a/4mtarif4,;a< e \,/a/do- co.vt
State or County rrr",
k
CBDG Funding
Address:
EN _ Not ApplicableR:
Phone
City:
Address:
zip:
DESIGN
Name:
_ Not Appiicable
Phone:
State
p
FEE SIMPLE TITLE HOLDER:
Name:
Add
Clty
zip:
le
ress:
Phone:
COMPANY:_Not Applicable
Phone:zip
Name:
Add ress:
City:
OWhlERl 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. Lucre Countv makes no representation that is grantinq a permit will authorize the oermit holder to build the subiect structure
which conflicts with anv applicable Homeownersassocia"tioh rules, bvlaws or and covenants that mav restrict or pr6hibit such
structure. Piease consult with your Homeowners Association and review your deed for any restrictions which may appiy.
ln consideration of the granting of this requested permit, i do hereby agree that lwill, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
l"he 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. lf you intend to obtain financing, consult
with lender an attorn commen work or recordi r Notice of Commencement
of 0wne as Agent for Owner
STATE OF
COUNTY OF
Sworn tcr
this stl'
(or and subscribed before
28!_
me of
by
VPhysical Presence or _ Online Notarization
day of
r-u urq 5rn*:L-
Name of person making statement.
Personally Known
----
OR P
Type of ldentification Produ L-
iSignatr"rre ry Public- State of Florida)
Commission ru".4il ct'lj 1'3_(5eal)*d:ll.:i.,,. MARY LEE i/AT-IlS
. _\u.,t' * Comrnilsio;r # HH 049498
,;H[WS Expires March 6.2025
'C or rLo* BonoM T ha erdget Notrry Seryies
REVIEWS FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW 'VIANGROVEREVIEW
DATT
RECEIVED
DATE
COMPLETED
SUPPLEMEUTAL CONSTRUCTION LIEN LAW INFORMATION :