HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number: 2" 1 1 0 Q7-3117
N�o L��� ^LL.
>r 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:
PROPOSED IMPROVEMENT LOCATION:
O
Address: 2-0 ��`A�r o!!-*%'o A I>Y'
Property Tax ID #: Lot No. Id__
Site Plan Name: 1°2.0 tt Block No. T
Project Name: C�O.lr''p141��4_4_
DETAILED DESCRIPTION OF WORK:
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 _ Shutters
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: ( � 1f
Cost of Construction: $ \ D d 00O
(Affidavit required)
Generator
Sq. Ft. of First Floor:
Windows/Doors _ Pond
Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name aG �'Q- Y'`
K
Name:.e$
v1MR:
Address: M 0 T2aAwQ, &yy++1
D I>Y' •
Company:'��'CVH,-Q.
City: %'r+ 1?l-4-r be,
Zip Code 3Z�'6�'~5 Fax:
Phone N -7 0-4L J dar O;L
State:
o E-
Address: M6 0 !\%
City: �yjr lbwc�ey-ct44e State:
Zip Code: //3'�3 a'� Fax:
Phone No(>
Mail: t�lorvih&on_ 04- OJA i®!A%Nk !%k •COS
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail 3 (N o i�
State or Coa4itq-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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNE /ENGI 1NEER: Not App (cable MORTGAGE COMPANY: Not Applicable
Name. 0%-% e1� �K `v!"e°e�'t�` Name:
Add,r�4eE�s. 4 4.veate�.tNt.i ta.t9 i ® Address:
City: V%V avr '0 State: City: State:
Zip:3315'Z. Phone /'—' Zip: Phone:
FEE SIMPLE TIT LE 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 representatiorrthat is granting a permit will authorize the permit holder to build the subject structure
which conflicts with anyl applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consul t 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 pcisted°on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or rney before commencing work or recording our Notice of Commencement. ct
Rev
U
Lessee ontracto Agent for Owner
=OFA /
COUNTY OF t�Y ow rd
Sworn to (or affirmed) and subscribed before me of Physical Presence or Online
Notarization
this 'µday of 2arT o� by �
Name of person making statement.
Personally Known OR Produced Identification `--�
Type of ldentific tion Produ d r4. 1�. L
(signature of Notary Publ4Sta fFlorida)
°��Y �•�� Notary AUCIA
Commission No. ,�JD (Seal) � - State of of Florida
�:;�`�` Commission # HH 35074
• `••'.?'qF r.�• My Comm. Expires Aug 23, 2024
• Bonded through National Notary Assn.
REVIEWS
� FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
• o
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW,
REVIEW
DATE
RECEIVED
•
DATE
COMPLETED