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HomeMy WebLinkAboutmusarra permit app All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: 9V.WOE Cf � ` 0 ° ' " Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential X 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 CBDG Funding PERMIT APPLICATION FOR: re Yoe PROPOSED.IMPROVEMENT LOCATION: Address: Property Tax ID#: 1 5 3 011 � 00 0— 3 Lot No.�_ Site Plan Name: it u1so�0 Block No. "Project Name: l Y // DETAILED DESCRIPTION OF.WORK: imfn I! . I_rw? 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 Total Sq. Ft of Construction: Z= Sq. Ft.of First Floor: ��2_Z Cost of Construction: $ <VCJ Utilities: _Sewer _Septic Building Height: ©�N CONTRACTOR: Name masovtq Name: I Address: 0 0 Company: G'l City: State:_ Address: Zip Code: ' Fax: City: State: Phone No. E- Zip Code:.3z ik Fax: Mail: Phone No Ii aaa>DiS-Aso Fill in fee simple Title Holder on next page(if different E-Mail Y1j 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: ANot Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: of 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 consu t 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. 12V,111700�16, 0 �� k Signature of Owner Lessee Con ractor as Agent for Owner STATE Of FLORIDA / COUNTY OF ��I C.UO C, Sworn to(or affirmed)and subscribed before me of X Physical Presence or Online Notarization this day of 1 ( ,20 by Sri s Colkth' Name of person making statement. Personally Known OR Produced Identification Type of Identification Produced Z---" Z�� Signat No Public-State of Florida) ro;�taY F KATHERINE HAVENS Commission No. (Seal) >: MY COMMISSION#130165030 / EXPIRES:DEC 04,2021 wa« Bonded through 1st state insurance REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev