HomeMy WebLinkAboutVeres gas permit app (2)All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number:
��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: �� `�� � .�.�
Address:
Property Tax ID #: ��� c�' ► -�=- d C) � ...- �.� �, ?�'� j,���,) -'^ '�,;.�
Site Plan Name: ��'� �"'Ci�
Project Name:
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit -check all that apply:
_Mechanical _Gas Tank�`Gas Piping _Shutters
(Affidavit required)
_Electric _Plumbing _Sprinklers _Generator
Total Sq. Ft of Construction:
Cost of Construction: $ I ,� ���(�
Lot No.
Block No.
_Windows/Doors _Pond
Sq. Ft. of First Floor:
Roof Pitch
Utilities: _Sewer _Septic Building Height:
Name .. �f � �
Address: � �
City: �;� t'��--�- �-�� � � .4 � State: -�
Zip Code: �; ��" `� _Fax:
Phone No.�� �� -�-� �� -- ���� E-
Mail: � e•
Fill in fee s mple Title Holder on next page (if different
from the Owner listed above)
Name: `"
Company: : '
Address: � �,/
City: �`�/t rty� State:
Zip Code: '���-��'�� Fax:
Phone No � '� `� �'
a
E-Mail k^• - 'w-i
State or County License � `.� �d
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
x. ���' t�,i 4f��' ��� �b+����l���i�N ��E� ��"�,��
�
��� "J � �£ x3�i">�y ��k. 'X.tY3
.i '.'i�` � xaY�g Nn ,. ...
.� ..... s.. , .,
� t I .�
.. .: .r ,, w. \,. +. .;.... ,� M :.. ,a. xK,:. iw
,Fi
T'°$"E fir;; ^�.Y�iww ��.�"�.. #
$ x v ..ar". - ...� . �
i f '.�t �� � "'��""?.
,_..� .e .� �.
., ..k % +t.. '..
4-�..
DESIGNER ENGINEER:
____. Nat Applicable
MORTGAGE COMPANY:
r e
Nat Applicable
Name:
Name:
Address:
Address:
City:
State:
City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLpER:
� Not Applicable
I�ONDING COMPANY:
Nat Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
.....
Zip• Phone•
vvit7YC15/ t,.VtV E KH4 t UK RttiUV) (:Application is hereby made to obtain a permit to da the work and installatiian as indicated.
1 certify that no work ar installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is ranting 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 revtew your deed for any restrictions which may apply,
In consideration of the granting of this requested permit, t do hereby agree that l wi11, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following Buiiding permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, waits, signs, screen rooms and accessary 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 retarded in the public retards of 5t.
Lucie County and pasted on the jobsite before the first inspection. If you intend to obtain finarlcing, consult
With lender Car an attr►rnav hafnra rnrr�manrinn.ernrtr .,.- rt,...,..,.1:.,.....,..,, e�_..:__ _r ,K___
_. _. _ ___..... _.. _... ., ,,.. .. .,.. ...rv.wu vu� �Vv1.It.6 v1 4VIif1i7C77GiSr r17:,''77 C.
����
Signature of Owner/ Lessee/Contractor as Agent #or Owner
sTATE OF FLO�
COUNTY O� {1 C'�,► �� i�1 ► '�i' �"
Sworn to (ar affirmed) and subscribed before me of Physical Presence or Online Notarization
this � day of _ i.'�i f' �- o#, �'' �°' , 20� by
Name of person making statement.
Personally Known OR Prodr� Identification �,
Type of Identification Produced
..
., �-
(Signature of Notary Public- State of FI
��1i .>�° Notary Public State oi' Florida
Commission Na. .�1iSea1} � Danielle Zimmerman
Q My Commission
HH 167198
°rw� Exp.9i9r2o2s
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev