HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: _ ot Z��3'k Permit Number:
v O L�U �.
.
AWN
'- `n i 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 CBDG Funding
PERMIT APPLICATION FOR: �kwr, &o Lei) V--
PROPOSED IMPROVEMENT LOCATION:
Address: (� L"�)J '�? oI`L&..' �YISf
Property Tax ID #: A-15 O Z- - U00- 0
Site Plan Name:— vvi (,Its- _
Project Name:
DETAILED DESCRIPTION OF WORK:
LM�i n.� G� W-Xll
�r1R11 AIR.' a.dL.fii JU t [l�Y, /. 4Y) f'Ut-la . (' A n.,A c, . \ a.A M.11,,M" rut .
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank _ Gas Piping
i( Electric X Plumbing Sprinklers
Total Sq. Ft of Construction: V�O
(Affidavit required)
Shutters Windows/Doors
_ Generator Roof
Sq. Ft. of First Floor:
Lot No.
Block No.
Cost of Construction: $ , 000. C)J Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
Name i Y"' aw'-, F--'-'MAJ
Address: `'Ilv eaD G .0�)03
City: JLnb6n J1, State: kL
Zip Code:Fax:
Phone No. 4rbI -- 133 L E-
Mail.
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
Pond
Pitch
Name: 1,&Duy-2 1s`%i _—
Company: 5 G�YS. 10, c.
Address: V\w 'C
City: %.c,iU St e:
Zip Code: 2MC14= _ Fax: _ 'I] - Vjh)- 00-lo
Phone No ✓11a- 10�1�- Go�� _
E-Mail kA-A,,t&U Q iJ►r�
State or County License
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.
I. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: I
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable I BONDING COMPANY:
Name: _
Address:
City:
Zip:
Phone:
Not Applicable
Stai.e:
Not 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 our Notice of Commencement.
�—'44fV'4_,VJ_ Lf4 �Q�
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORI A
COUNTY OF
Swor (or affirmed) and subscribed before me of
this day of 20 � tt by
1
Nanhe of person making statem nt.
Personally Known 4 OR Produced Identification
Tvpe of Identification Produced
of Notary Public- State of
Commission No.� &kLP �[Seal)
REVIEWS I FRONT
COUNTER
DATE
RECEIVED
DATE
COMPLETED
X Physical Presence or Online Notarization
_5•y SANDY M. FREUDENTHAL
Commission # GG 169508
Expires Deoember 19, 2021
?►! '4 j Baled TMu Tmy Fain A+ unm 800-385.1019
ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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