HomeMy WebLinkAboutBuilding Permit Application � Z
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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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:
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Address: , ! �3 �/
Property Tax ID#: `/- y 70 /7_a ' ��a / Lot No. L n
Site Plan Name: i4krG JJ947 4-Al Block No. �D
Project Name:
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New Electrical Meter Second Electrical Meter
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Additional work to be performed under this permit—check all that apply:
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Mechanical Gas Tank —Gas Piping —Shutters _Windows/Doors. _Pond
— .
--€fectric —'rlu—m bing —Sprinklers —Generator —Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ Utilities: —Sewer _Septic Building Height:
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Name �2 Name:ROBERTS BRUHN
Address: .0 z-e Company:LOUDEN POOLS I
City: FnO/ Stater Address:4306 S US 1 ;
Zip Code: qg Fax: City: FORT PIERCE State:FL
Phone No. Zip Code: 34982 Fax: 772-465-1063 I,
E-Mail: Phone N0772-465-2700
Fill in fee simple Title Holder on next page(if different E-Mail- pwxlisa@yahoo.com
from the Owner listed above) State or County License cpc1458612
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.
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DESIGNE /ENGINEER:; —Not Ap licable MORTGAGE COMPANY: _Not Applicable
Name:�� 4/.c�diftoe_r•mil Name:
Address: 4/7 Z 7 /U.&,1 A Address:
City: C-'/LO State: City: State:
Zip: _'5Z74,A Phone Z Zip: Phone:
FEE SIMPLE TITLE HOLDER: —Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone: e
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.
Inconsideration 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 appliICations are exempt from undergoing a full concurrencyreview: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
T r_..-_.with lender-oran-attorne -before..commencin work or_recordin - .our Notice_ - mmencement.-- -, - --
Signature of Owrier/_ Lesse /Contractor as Agent for Owner Signature of- ontractor/License Holder
STATE OF FLOR /' STATE OF FLORID /
COUNTY OF � C•C-� e_ �= COUNTY OF ► r GCt�
Sw� Pgrn to(or affirmed)and subscribed before me of Sw rn to.(or affirmed)and subscribed before me of
7_ ysical Presence or i • Online Notarization ''Physical Presence or. Online Notarization
this_ day of /YLT' .209J(by this 14�day of O «' .202JI!by
/4el< k=&e_ffl^�J ROBERT S BRUHN l
Name of persob making statement. Name of person making statement.
Personally Known OR Produced.Identification tY0 Personally nown . x . OR Produced Identification
Type of Identification Ty ent fication
Pr P d _ed
ignature of otary Public-State oy . • `) ff55i nature of N lic-State of Florida
* Commission#GG8 160 a'ORYPue, SHERRI FEHLMAN
Commission No. ExpiresMarch14,2 2 •'"'••
I) commission No. 003ian#GG 187160
9rF o�� GwWedThtuB*etNotW
o�F` N9r `oe Expires March 14,2022
REVIEWS FRONT; ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
�. DATE
COMPLETED
Rev.5/6/20
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