Loading...
HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ®I Date: Permit Number: alol • #nzyo 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:�jLj,I +C,- Uj PROPOSED IMPROVEMENT LOCATION: Address: 5-5 0 9 X �1 I Property Tax ID #: ) 3 © (3 O S L/ ^ � 0 ® � 5� Lot No. Site Plan Name: Block No. Project Name: I DETAILED DESCRIPTION OF WORK -JV In5+60)i 00i ad09- 0332- 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: Cost of Construction: $ J D 000 Generator _ Windows/Doors _ Pond Sq. Ft. of First Floor: Roof Pitch Utilities: _ Sewer _ Septic Building Height: OWNERAESSEE: CONTRACTOR: Name ;:I-i,t h1h, � Jacw an d Name: 0 A LID q C'c/ Address: 550 of Kf � lal-tli",4 Gw-e- -� Company: 110160 IA)(JC'f sGT`e2 U City: E+ P C e ✓Lr,e State: Ft- Address:e� 3L J :3_o k n S*� ►2 Zip Code: _ 3 `'I J / Fax: City: F+ I- State: _ Phone No. Zip Code: Ycf S 7 Fax: E-Mail: Phone No %1i Z 2- I -- 3 / Fill in fee simple Title Holder on next page ( if different E-Mail r� O+e q s Cy M from the Owner listed above) State or County License 300 L0 3 If value of construction Is 2500 or more, a R€0 i ff B N8fice of Commencement is required. If value of HAVC is $7,500 or more a REC®R®€®Ne IFS $ m nce t' eke*fired. 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 Home Owners Association bylaws that any applicable rules, or and covenants may restrict or prohibit such structure. Please consult with your Home Owners 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'viiith 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 attorneybefore commencingwork or recordingour Notice of Commencement. Rev. 1 SUPPLEM ENTA� CONSTRUCTION LIEN LAW�INFORMATION .1-f ., .i',tT il.., s,t''isA.,RF yt � ..,;F',hsTM17t ass..,. .XI ,, ..#>�ti"%t9` r.r.! P. rhi,r R fs.9 �t.lz. J._Y,'.�Tl/s s. ��. f q�.u+l.rc.. �"a'1'1.. [4 .!? � . �Yl .(I'i n�Jt }�j�.�!{M1�•tiL � .aY 2$ r.: 1,r!'1.41.M,. fi 2VSY.t.�s ,�. ti� . r.....'Y ..�sR s1K A![ DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: lor',dk ' ne U�- Name: Address: I T Address: City: or k State: F4 City: State: Zip: 339$2. Phone SJ3 a91327Z Zip: Phone: FEE SIMPLE TITLEHOLDER: _Not Applicable BONDING COMPANY: Not Applicable Name: Name- Address: Address: City: City: Zip: Phone: Zip: Phone: c rwG%��po Sr a: tureof:Owner%l:esse%Contractor-as-l�ent.for•Q Signature Contractor/License Holder of STATE OF FLO�DA STATE OF FLORIDA COUNTY OF Ai n� I { AC:1-e. COUNTY OF Sworn to,(or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of ✓Physical Presence or Online Notarization Physical Presence or Online Notarization this�dayof 'fUr►e .2920 by this day of .2020 by Zozl �u l j �-. Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced �