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HomeMy WebLinkAboutBuilding Permit Application0 All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED )) Date: Permit Number: OR -.. - ° .._���- ' : , 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 _PERMITAPPLICATION FOR: Address: `3�© 1�� r4- 1{r Property Tax ID #: ( Q 1 f �a©S' 000 Lot No. Site Plan Name: Block No. Project Name: New Electrical Meter Second Electrical Meter (Affidavit required) Additional work to be performed under this permit— check all that apply: _Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors _ Pond Electric _ Plumbing _Sprinklers 1 _ Generator _ Roof Pitch A1gr1�GIL �jDG'^ Total Sq. Ft of Construction: ? y At Sq. Ft. of First Floor: -Cost of Construction: $ 1p 0 049 Utilities: —Sewer _Septic Building Height: Name 1 , L-- -t �'nn1 Name: Address: 3 S �-� ��— I� Company: City: �Or"� `%� tJr- L State: �� Address: City: State: Zip Code: sl) G, Fax: Phone No.:::7q2— 2 L42D E- Zip Code: Fax: M a i kiA)11 it,� C +y S1 qMo,;/ , C-zWk 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. 0 DESIGNER/ENGINLLK: Name: Address: City: Zip: Pho FEE SIMPLE TITLE HOLDER Name: Address: City: Zip: Phone: _ Not Applica State: Not Applicable MORTGAGE COMPANY: Name: Address: City: Zip: Phone: BONDING COMPANY: Name: Address: City: Zip: Phone: Not Applicable State: Not Applicable 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 r Home that Associa ion rules, will and covenant holder maybrestrict or prohibit such re which conflicts with any applicable 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, lls, signs, screen rooms and accessory uses to another non-residential use accessory structures, swimming pools, fencEs; :^ca WARNING TO OWNER: Your failure to Record a Notice of Coirrri2ncement 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 'obsite 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. 7.,A) Signature of Owner/ Lessee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF Physical Presence or Online Notarization Sworn to (or affirmed) and subscribed before me of this day of 20_ by Name of person making statement. Personally Known OR Produced Identification Tvse of Identification Produced (Sig at re of Notary Public- S e of Florida) wY " INGRAM,RA'HMING Commission No. (Seal) }. ;t's ;,. k: M1(COMMISSIOPI#GO275030 EXPIRES,� cembE; 20 2nr� } '.Fcaf4,.� 80odedThNlNotaryW •. : REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATEVIEWREV RILE MANGROVE W REVIEW COUNTER REVIEW REVIEW REV EW DATE RECEIVED DATE COMPLETED