HomeMy WebLinkAboutBuilding Permit Application I
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II APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: d 2�f Zi Permit Number: co l t Q'o �U�'
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Building Permit Application
Planning and Development Services
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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: 3S�
Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION IF WORK:
-e.Q <XC , o ; �1 1 Y,
New Electrical Meter 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
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Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ _2_,> 00 ®O Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE CONTRACTOR: r�r !
Name X1;'O 1\Af Uf VL C_-A OE Li4 Name: 40 ago, G cL/ n ( G
Address: 35 �.. � f�� Company: ,
City: tOp Y q44tl t! u b--L State:�L Addreess: O/ Z
Zip Code: `���� Fax: City.r_oraJ5P,,,-1IW< I State:
Phone No. `] ?2AZ(c, (59 E- Zip Code: 33C4 Fax:
Mail: Phone No 4��3
Fill in fee simple Title Holder on next page(if different E-Mail 1 c.2rol d 300® &rM h< < CO"
from the Owner listed above) State or County License�dS!93_)2cw
If value of construction is 2-500 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.
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blame: blame:
Address: Address: --
City: State: City: __ - - State:
Zip: Phone Zip: phone:
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FEIE SIMPLi.T&TL HOLDER: Not Applicable BOM135MG COMPAW: i _Not Applicable
Name: Marne:, - - -
Address: Address: .-- -. --City: —
Zip: phone: -- Zip: Phone:
OWNER/CONTRACTOR AFFIDVOTt Application is hereby made to obtain a permit to do the%vork and installation as indicated_
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie Count, 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 Horde Owners Assodation rules;bylavn or and covenants that may restrict or prohibit such
structure.Please consult with your Horne 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 Amendment's.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen roams and accessory uses to another non-residential use
WARNING TO OWNER:Yourfailum to Record a iNotke of Commencement May rwLdt in praying 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 intendlto obtain financing,consult
with lend or an attorney before commencin work or recording our Notice of Commencement.
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Signature o€Owner/Lessee/CoqyAftdFt91Fe6t for Owner
STATE OF FIL®RO% c
COUNTY OF U!-
Sworn t (or affirmed)ano subscribed before me of "Phcal Presence or Online Notarization
this; day of 20_11 by 6,
tame of person matting statement.
Personally Known OR Produced Identifiration
Type of Identification Produced .111. r-.01 fNF vii
.,•Gp�A1SSfoh••��9
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(Signature of Notary Public-State of Florida s` :•
Commission No. << Za2 (Seal} 7- +�W rsµ� ;'♦
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REVIEWS FRONT ZONING SUPERVISOR FLANS VEGETATION kATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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