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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLI%JjON TO BE ACCEPTED !{RFD Date: A10 V 0.1 Permit Number: cad nVi St Luo�e 20Z� %WM n9 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: 060 /,/,V1 _Aa.H / TZI0,•� /0A PropertyTax ID#: filo9�-7�'i G-��_33-Da0-D -Lot No. Site Plan Name: 1 Block No. Project Name: 7LE 14tr,*UM 40 Alehm DETAILED DESCRIPTION d OF WORK: rt�s v/a�/ .2e� ,5�,o�P r- rea,'✓) nv2V7 !�t 5LuPr (aJdo-, 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 Electric _Plumbing _Sprinklers _Generator _Roof Pitch ti Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ 7AA,9,oo Utilities: —Sewer=Septic- Building Height: OWNER/LESSEE: -CONTRACTOR: Name f5 k; Name: ee Address: 10DD 4) r4/4 lD 19 Company: '✓r cwG City: ;e d f Y loc e- - State: Addres ps: T// Or ,Zip Code: Fax: City: , f Peirce- State: f L Phone No. E- Zip Code:L. 3q MO- Fax: Mail: Phone No Fill in fee simple Title Holder on next page(if different E-Mail 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: _Not Applicable Name: Name: Address: 'Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: 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 representation that is granting a permit will authorize the permit holder to build the subject structure which conflicts with any,applicable Homeowners Association rules,bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Homeowners 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 before commencing work or recording our Notice of Commencement. sigfiatfkE of Owner/ ee/Contractor as Agent for Owner STATE OF FLORIDA�� ( { COUNTY OF Sworn to Lor affirmed)and subscribed before me of Phy�Presence Online Notarization this L ay of 206 by Name of person making statement. Personally Known OR Produced Identification�© Type of Identification Produced (Signature of Notary Public-State of Florida) Commission No. LE VAUGHN z°s State of Florida-Notary Public _* Commission � GG 270079 W Commission Expires Ga REVIEWS FRONT ZONING ' SUPE ISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev 0 2