HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: A "') I Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial
PERMIT APPLICATION FOR:I
PROPOSED IMPROVEMENT LOCATION:
Residential
Address:e(-�, c D c9ja, 161�- �r� r c �C�
Property Tax ID #: — cc-<p O Lai No.
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
. $ TUN C W 4 L` cJnr ir) to 3 Kw r 12.1
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional ork to be performed under this permit -check all that apply:
_�IVlechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Pond
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
oa
Cost of Construction: $ �, ��,� Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name: -)f��Ri(\
Address:
- /
Company: �,� I _F(P c* An r cA VY /4► (`
City: Y Zkc nn --j k-e_ tate: _C
Zip Code: Fax: —
Phone No. 'j c9► & -IE5�
Address: 5W s
Cit OCR �-} woe State: f
Zip Code: Zvq" Fax:q--V•-3L1b
Phone No O'er- yv-
E-Mail: +1 O
Fill in fee simpl tle WIder on nex age ( if different
from the Owner listed above)
E-Mail I 1A (?A; ; Al-061 C ri CQPY oih C
State or County License_ CSC) 9-/ L (4,33
• `•"•"_ `�• �'�••��• ua.uV�� IJ LJVV VI IIIUfC, d RC\.VKUrU IVULIce oT Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
— -- •-�•-� ��•• • j vn mrriuv11 ;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 commencing work or recording your Notice of Commencement.
Signature of 0 er/ Lessee/Contractor as Agent for Owner
STATE OF F IDA _
COUNTY O , V
Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization
this day of , SP ism � K-20A by
Name of person making statement.
Person >C OR Produced identification
pe of Identificatio Produced
(Signature of Notary Public- State of Florida )
Commission No. Qrf& iq (Seal)
REVIEWS
RECEIVED
DATE
COMPLETED
FRONT ZONING
COUNTER REVIEW
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KONNI LENAE DEWITT
Notary Public — State of Florida
# GG 166915
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Commission
5f1''I'I of
My Comm. Expires Dec 10, 2021
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Bonded through National Notary Assn.
UPERVIS
PLANS
S REVIIEWOR I REVIEW I VREV EWON I SIAEV EWLE I MANGROVE REVIEW