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HomeMy WebLinkAboutpermit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: SIF E.U. C­ - Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: P-cepl C ie G oraq,e 60C)P— Address: 135 M(II Q nnEf ]i CA F t- P i ercc El 34g4Q Property Tax ID #: I414 • -101 - 01(01 • Wo • Z Lot No. � Site Plan Name: Block No. Project Name: 4)n 41F ail/ r I lJ New Electrical Meter Second Electrical Meter (Affidavit required) Additional work to be performed under this permit- check all that apply: Mechanical Electric _ Gas Tank Plumbing Total Sq. Ft of Construction: Gas Piping Sprinklers Shutters _ Generator Sq. Ft. of First Floor: Cost of Construction: $ S-12 � .coo Utilities: Address: 13'ip-_ 09''llcimeI'7(' City: v--+-- picrcL Stater Zip Code: �-l4Q Fax: Phone No. (031 •331-�- • �i-� E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Windows/Doors _ Roof Sewer _ Septic Building Height: Pond Pitch Name: Ci5nn IL• C--,rCuC- Company: D -4 D G-iCUX15C- l'S Address: 43-V5 NlA) ErT}GI�p1'jSC nj - City: i9s1 Stater Zip Code: 3LLQ26 Fax:-r?2•L[(ap•'l(-3! Phone No ^l"12.44oO •r( (o 30 E-Mail Gt S C' C5D C. v State or County License 31 It 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. DESIGNER/ENGINEER: _ Not Applicable Name: Addre: City: _ Zip: _ State: Phone FEE SIMPLE TITLE HOLDER: Name: Address: City: Zip: Phone: Not Applicable MORTGAGE COMPANY: Name: Address: City: Zip: Phone: Not Applicable State: BONDING COMPANY: Not Applicable Name:_ Address: City:_ 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 on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attornev before commencine work or recordine vour Notice of Commencement. k AL Signature of Owner/ Lessee/Contract as Agent for Owner STATE OF FLORIDA COUNTY OF 6A-,r V Ljc�-ie, l Swo n to (or affirmed) and subscribed before me of - /Physical Presence or Online Notarization this)© day of=��.,,a�',um�� % 20r�k by 6+10ie 61fciCC Name of person making statement. Personally Known '\/ OR Produced Identification Type of Identification Produced W�'rY i'�t�/ (Signature of Notary of Florida ) iPublic- 7State Commission No. t1 �( 1 i� ��►�1YP�a MICHAELWALZAK (Seal)°•'"''•�'O Commission#HH087991 ae Expires February 2, 2025 . I' of �`oe, Bonded Thru Budget Notary Service$ REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev 5120121