HomeMy WebLinkAboutBuilding Permit ApplicationAIIAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:i0 -/ 7 -2t /O*f, # PermitNumber:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (172\ 462-1578
Commercial Residential X
CBDG Funding
Address /o 70 I 5. 0c*n 0.. f 7// I"rr"Ft.3//r7
Property Tax lD #
Site Plan Name:
qT//-8or- udZ Q@ r Lot No .7//- /62
Wlzcs t)tge--Block No
Project Name 7t/
m.(
fio ;2.P/
{Lrt" ,ot'" /r; r,<v,rol *, Tprtlaitn
New Electrical Meter Second Electrical Meter (Affidavit required)
Additional worl< to be performed under this permit * check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
-
Pond
-Electric-Plumbing-Sprinklers-Generator-Roof-Pitch
Totai Sq. Ft of Construction lto Sq. Ft. of First Floor:lto
Cost of Construction: $/700. oo Utilities: f( S"*",
-
Septic Buiiding Height 8-fr
lf value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
lf value of HAVC is 57,500 or more, a RECORDED Notice of Commencement is required.
PERMIT APPLICATION FOR:fru-n f; /;crt
PROPOSED I M PROVEM ENT LOCATION :
DETAILED DESCRIPTION OF WORK
o :An /.o
OWNER/LESSEE:CONTRACTOR:
Name Jose ol flofo
Address: /0ZO t 5- Oceon P.. # 7/ /
City , f,eoreo fiar/
code: J/qSZ Fax:
State:a.
zip
Phone No
Mail:
772- ?// -
"d
fg E
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name:
Company
Address://
City Icttftn a /xate: Fl.
Zip Code:
Phone No
74717 rax: 772'272 '2 / 7 /lo-
E-Mail -m,t
State or County License
CONSTRUCTION I N FORMATION :
Name
MORTGAGENot ApplicableNEER:
Phon
State:
Address:
Name:
D
City
zip:
City: State: _
_ Not Applicable
Phone:
FEE SIMPLE TITLE HOLDER:
lrlame:
Address
City:
zip:
Applicable
Phone:
_Not Applicable
City:
Zip: _Phone:
Address:
BONDING
Name:
CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certifli that no work or installation has commenced prior to the issuance of a permit.
St- l-ucie County makes no representation that is granting a permit will authorize the permit holder to build the subiect structurewhich conflicts with anv applicable HomeownersAssocia-tioir rules, bvlaws or and covenants that mav restrict or prfihibit suchstructure. Please consult with your Homeowners Association and feview your deed for any restrictions which may apply.
ln 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
be recorded in the
twice for
improvements to your property. A Notice of Commencement m ust public records of St
Lucie County and posted on the jobsite before the first in spection.If you intend to obtain financing, consult
with lender n attorn menct work or recordi r Notice of Commencement
Owner/r as Agent for Owner
I
{t
Presence or _ Online Notarization
Name of person making statement.
Persona Known OR cation t---
Public- State of Florida)
Commission No.EEJblo(07 s*n -tlt?;.
*B#"'
JESSE DOSS
Commission # GG 26.106S
Expires Septembe r 27 ,2022
E0ndqC lhr! P!.j061 Noirry Sgrylces
REVIEWS FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
SUP NSTRUCTION LIEN LAW INFORMATION:
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