HomeMy WebLinkAboutBUILDING PERMIT APP - ERIE DR All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
,,:-L LLLCLL
L'� ' 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: 19 O +mac,
PROPOSED IMPROVEMENT LOCATION:
Address: J )4 S 7
Property Tax ID#:J Ll 33 0003 — rj)L Lot No.
Site Plan Name: Block No.
Project Name: Tn1 t\ -N� fit_
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 _Gas Piping —Shutters _Windows/Doors _Pond
_Electric _Plumbing _Sprinklers _Generator Roof 1 2— Pitch
Total Sq. Ft of Construction: > Sq. Ft. of First Floor:
V
Cost of Construction: $ Utilities: _Sewer _Septic Building Height: 17-
OWNER/LESSEE: CONTRACTOR:
Name �� �- -F r L Name: u�=' U
Address: Company: T y lLiOA
City: Stater Address:
Zip Code: 1 0 0 c Fax: City: —C�^<1��nG State: f' L
Phone No. E- Zip Code:� 46 1 Fax:
Mail: Phone No 176� t —f 00
Fill in fee simple Title Holder on next page (if different E-Mail JJ✓"At I of A % S 41(t.� ..116o 0
from the Owner listed above) State or County License Cr;c / 3',l)i 1,13
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: — Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: 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 conflicts with an applicable Homeowners Association rules,bylaws or and covenants that may restrict or prohibit such
structure. Please consuYt 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 sted On the jobsite before the first inspection. If you intend to obtain financing, consult
with lender en ttorn before commencin work or recordin our Notice of Commencement.
I A'
Signature of Owner/Le see/Contractor as Agent for Owner
STATE OF COUNTYOFORIQQI � /1 r
`�1 e_;e fro✓M.fd
Sworn�p(or affirmeeq)) ndpsubscribed before me of _Physical Presence or_Online Notarization
this �S'ay of f 20>-I by
�a r-w ,IL1111eY111111///�
Name of person makings ement. N i• BI.. _yAr S
Personally ow OR ProducedMn2lficon�R�i ''
Type of l ptif roduced
oP a me �27
ature of Notary Public-State of Flori d ..c Unaaw^°,
Commission No. (Seal) / /SrA F1
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
BATE
RECEIVED
DATE
COMPLETED
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