HomeMy WebLinkAboutBUILDING APPLICATION - BRONTEAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
4Y0 SIC
0
n o
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial_
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
WROPOSED IMPROVEMENT LOCATION:
Address
Residential
Property Tax ID#: 5115 -?05- I,)1 /3- DDO- Z
Site Plan Name: Att-%0ff%ta. gX111? / CQM 740, 5 O/7YP1�
Project Name:
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:
Lot No. I I Z
Block No. 1
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
_Electric _Plumbing _Sprinklers _Generator ✓f(oof 51/7- Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ Z'P.. ADD. O/-?
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height: /D
Address: b4rW&Wy AYllCir
City: LDOr�f z-fi cZe State:,
Zip Code: 3`y 7 G Fax:
Phone No. N / 4 E-
mail: &1
Fill in fee simple Ttle Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
Name: 7U�C2 Lar4
Company:-iZPL5 'ilne Halo/ ROOF Z*md&'�
Address: 3/HO S6 Uz"AnK sii
City: 5J5UQr'F State: FL
Zip Code: Fax:
Phone No �3Z- 3Zs ifp
E-Mailp/r>.'fs�h/nf�/2�rnl��r DP�S.nfF
State or County License C Dk� ►3323' ;6
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.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Name:
Address:
City: State:
Zip: Phone
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
FEE SIMPLE TITLEHOLDER: _ Not Applicab a NIDING COMPANY: _Not Applicable
Name: ame:
Address: Address:
City: I City:
Zip: Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT:
I certify that no work or installation has a
areby made to obtain a permit to do the work and installation as indicated.
to the issuance of a permit.
St. Lucie County makes no representation that is krantigg a permit will authorize the permit holder to build the subject structure
which conflicts with any applicable Homeowners sociation rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners A sociation 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 f •lure to Record a Notice of Commencement may result in paying twice for
improvements to your operty. A Notice of Commencement must be recorded in the public records of St.
Lucie County and p ed a jobsite before the first inspection. If you intend to obtain financing, consult
with Ipncipr n pv hpforp commencing work or recording vour Notice of Commencement.
Sigrratur r/ Lessee/Contractor as Agent for Owner
ST F FLO DA �11
C OF dtka'1
Sworn to (or affirmed) and subscribed before me of
Physical Presence or _ Online Notarization
this J day of 64Ctybe✓ 20,1-L by
Name of person making statement.
Personally Known �c OR Produced Identification
Type of Ident' icati roduc
(Signature of Notary Pu i to e o o ida)
Commission No. G G0D I (Seal)
UCommissiolTHERESM
ryPuhlic-mmissio
Pomm. Ex
rough Natl
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
I
COMPLETED
Rev 5/20/21