HomeMy WebLinkAboutbuilding permit app - mayrides FFDate:
BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
((\� Permit Number:
" 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:
Address: � 4°�c �c R �
Property Tax ID#: - no 001 9L-G 0' 0 1 Lot No.
Site Plan Name: Block No.
Project Name: K4ctgr--1J .S
DETAILED DESCRIPTION OF WORK:
New Electrical Me er Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit-check all that apply:
_Mechanical —Gas Tank _Gas Piping _Shutters _Windows/Doors _Pond
v/Electric Plumbing —Sprinklers _Generator —Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ t Q WCX 0 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name �'1f�(fy1Gt.S G�_V1D, ���¢ P (���"�sAi ) Name: pp
falq CJa Company: Y Address: v^P. �ti Z `L Com an
City: P State:yEL Address: l fIyt-
Zip Code: _Fax: City:L0knrY I-LU.0 State: !2L
Phone No. E- Zip Code: ��� Fax:'X�r 1 �'N,� t.5�
Mail: Phone No `j-)�0
Fill in fee simple Title Holder on next page (if different E-Mail C - �(Ot Mmh,
from the Owner listed above) State or County 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.:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: �i
i Name:
Address: �1
�fiq r�. Address:
City:
't�' 5 t City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: X Not Applicable
Name: SAME AS OWNER Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFiDV1T: 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 any applicable Home Owners Association rules,bylaws or and covenants that 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 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 posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney t efore commencing work or recording our Notice of Commencement.
Signature of Owner/Le see Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF C4. I
Sworn to(or affir ecl and subscribed before me of ysical Presence or Online Notarization
this day of 20'�, by
Name of person Vking statement. _
Personally Known OR Produced I SRl ;
t' i ion Pr duced =*
Type of(den �orrtmfistorr#HH041043
E#hv Sep tuber 13,2024
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(Signature of AtVy Public-State of Florida
Commission No. (Sea[)
REVIEWS I FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE =REVIEW
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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