HomeMy WebLinkAboutApproved plans by Walt Pride Building Permit Application and DrawingsAll APPLICABLE INFFO9 IMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: L�� WI �I Permit Number:
9U AGM
V. 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: sf-v V 1 C �
' • • -7�i7iis.�i:ltl�.1►l:�1[t1'�Il�ii
Site Plan Name: 1 1 . i
Lot No.
Block No.
Project Name: i-I MS Pe-ri i y
New Electrical MeterSecond Electrical Meter_________
�CONSTRUCTIGiv f�,l-0i�i`v5 � ���*, � _
Additional work to be performed under this permit- check all that apply:
_Mechanical , Gas Tank —Gas Piping
vt`lectric _Plumbing —Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $
EL:
— Shutters
(Affidavit required)
____ Windows/Doors _ Pond
_ Generator ^ Roof _ Pitch
Sq. Ft. of First Floor:
Utilities: __ Sewer _ Septic
Address:' alcl�(._Svc! TV6iC) V\/pc.\l
City: eoO �+- aA&., ¢_._ State:
Zip Code: Fax:_
Phone No. E-
mail: i QSi9 E,6 ie, oso- . Y1k-t
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Building Height:
Name: , )0 Y.A 1 KE:Z U,,kk ¢' VJ 1
Company: a 1A xAQ �CA-nr,
Address: ? RCVS PEJ0 W0_J e_ /jy4LQ U-C,
City: poi(+ eUU CA State: 3�
Zip Code: ' -Q q j Fax: Z74-?f0 ,F_92V
Phone No �21`7 a -Pilo - a-ezicf
E-Mail JASan P 5Ce Lis e-- 0-e-t
State or County License CC 13009/3 2-
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.
—Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: of Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: --Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: " Not Applicable
Name:
Address:
City:
Zip: _ Phone:
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 reppresentation that is rantingB a permit will authorize the permit holder to build the subject structure
which conflicts with an appi cable Homeowners�ssociation rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consu t w th your Homeowners Association and rev ew 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 as f osted on the jobsite before the first inspection. If you intend to obtain financing, consult
With lendeP'br an 8ttornev before commencing work or recnrdinp_ vnur Nntirp of CnmmPnramant.
Signa (O r/ Lessee/ ntractor as Agent for Owner
STATE 0 LORIDA
Vlo� hn1
COUNTY OF i
Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization
_
this z U day of C ryjMaQIL� , 20? ( by
•J>�soN '�fry��y-so�v
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification Produced fh r h21 S��f,L "_R
(Signature of NdItpry Public- State of Florida) ; ...,
TAYLOR MJONES
p I /?'..4,w __ Notary P
Commission No. C / L � Q Seal t=' y� _;' i rY Public - State or Florida
m (Seal) ., Commission - GG 359418
n..
a_ My Comm. Expires Jul za, 2o23
Bonded through National Notary Assn,
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