HomeMy WebLinkAboutBuilding permit app, detached garageAll APPLICABLE INF7 MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 l 3/7 I Permit Number:
(� 1Jo
P 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: �L _ �w,z� fo� D-evaCv\-ec1
[PROP OSED IMPROVEMENT LOCATION:
Address: -I V "1 Z-c.0 `lq J t P-K-( -r 9--011- Yl--C 1 p%�aL rL
PropertyTaxlD#: -3 40 Z - 69 .)- 02-<�i
Site Plan Name:
Project Name:
DETAILED DESC
C
(0o p- +&
Place S2
New Electrical Meter
f C4
L1\4
Second Electrical Meter (Affidavit required)
CONSTRUC9'ION INFORMATION:
Lot No. �i( ' 13
Block No.
Ili
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
V /f z Pitch
Total Sq. Ft of Construction: �I�=5-1200 f
Sq. Ft. of First Floor: I 2-C70
Cost of Construction: $ SC10 Utilities: —Sewer Septic Building Height: [ S
r
ER/i9SSE]E
CONTRACTOR:
Name \%\ crca k Yl1Ck Oa (bi I
Name: 2Ll cksr
Address: o C�cS i' a .4-
Company: IfIS COS 0 tl^c'+V-e9-1t�
City: (-Y pinnt-tY(_.t_ State: iL
Zip Code: ,)W(4 y Fax:
Phone No. E-
Address: 33`( Soi
City: Q�/Il C 1 �`� State:
Zip Code: (Q cf� Fax:
Phone No -71
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail
State or County License 01�
IT Value of Construction Is Z500 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:
Not
Name:
Address:
City: State:
Zip: Phone
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
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 maicatea.
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 anj 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 attornev before commencine work or recording your Notice of Commencement.
of ssee/Contractor as Agent for Owner
SignZOF
STA FLORIDA c
COUNTY OF
Sworn to (or affirmed) and subscribed before me of x
Physical Presence
or Online Notarization
this 3tr day of V-bVeIAt-4 V 20_2A by
�T2rr��y C15cd
Name of person making statement.
Personally Known /� OR Produced Identification
Type tification Produce
-/
�. r1�V �--1y_
(Signature of Notary Public- of lorida)
1^pry
NANCY HAGERHORSr
Commission No.q(Selal)
%
Notary Public
c
State of Florida
-J%FJ
Comm#HH167992
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Expires 8/23/2025
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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