HomeMy WebLinkAboutBuilding Permit Application � a
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: f V
P�CEfI�E'p
27..LUCD 1 11 ` Nov 0
Lucie Cou
Permittiri iding 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)452-1578
PERMIT APPLICATION FOR:
FPR4POSED IMP'R01/EMENl'SLOCATIOIV {
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Address: <S'z)O 1��•i12�'f ei r.
Property Tax I D#: �\va.- _�� 3- O a'7 r. 00 0 - b
p rtY L.ot N o. 9 !o
Site-Plan Nanio: Block No.
Project Name:
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New Electrical Meter Second.Electrical Meter
CONSTRUCTION INFCIRMATIOfiI f
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Additional work to be performed underthis permit—check all:that apply:
.,Mechanical _:Gas Tank .Gas Piping _Shutters _Windows/Doofs _Pond
_Electric _Plumbing _Sprinklers _Generator X Roof -S/t Pitch
Total Sy.Ft of Construction: 3036 Sq.Ft,of First Floor: . -
Cost of Construction:$ 076;, 000 Utilities; _Sewer _Septic , Building Fieghtc
01AINER/LESSEE _,S t CONTRACTOR
Name- GJC r I.c.S N• C) owe aL Name: 'Cn 1AQ1wNLq
Address: SSoa 'Dihc�r�a.. �F Company:�e 4 Suf G�cs♦ �oo�ina
City; ..YuY�- '�i e..t C.2- State:FL Address: 1$1.6- 6 6.
Zip Code: 3c4g$Q fax: Cit 1 oc � L
y: �- �-• 'l.�)Gi Stater
Phone'No. Qo?�/-G 3 3- :Zip Code: 3`•(1�i,y Fax:
E-Maih Phone No
Fill in fee simple Title.Holder orli next page(if different E-Mail /C./000F�ta_LCC�J n Ala:��
from the Owner listed :above) State*or County.License : _ G G /334 65'.3
WwAue of construction'is 2500 at 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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DESIGNER/ENGINEER: T Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City:. State:
Zip: Phone Zip: Phone:
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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 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 before commencing work or recording o otce of Commencement.
Signature of Owner lessee/Co tr as ent for Owner Signature of Contract Li se Ho er
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 5� COUNTY OF 5*./= Zue
sl�5 rn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization __k_Physical Presence or Online Notarization
this—g--dayof/1/r�1>em�o. Z8�'by this__$ Al
_dayof eoeznAer 282Tby
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Name of person makings tement. Name of person making statement.
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Personally Known_(�_OR Produced Identification Personally Known OR Produced Identification
Type of identification Type of Identification F
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Produced Produced
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Signature of Notary Public-State of Florida} ig ature of Notary Public-State of Florida) d o—.-Um
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Commission No. � .3//��� (Seal) ''° '1y�`; Commission No.�C 3/136 S (Seal) ;y 0 D
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REVIEWS FRONT ZONING j PE-N490R PLANS VEGETATION SEA TURTLE MANGROVE °'� nD
COUNTER REVIEW F. IO REVIEW REVIEW REVIEW REVIEW y 4M2.0
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