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HomeMy WebLinkAboutBuilding Permit Application Wiad All APPLICABLE INFO MUST BE COMPLETEEP0@44O&ATION TO BE ACCEPTED v Date: �Z42 (t©� Permit Number: l 'oz ao ��LME °-MIMW " Building Permit Application Planning and Development Services r Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 PERMIT APPLICATION FOR: .z(F aim pe-e4f. V T,- Address: f'd®g IRJf Df�� Aver 75 L -, f�� 3Ligr-S--� Property Tax ID#: 3915 .�1 D DOOG'1 Lot No. 11 Site Plan Name: fpeyu Block No. 9 Project Name: iw 2. t D iZt;fM(V� SKI � - IZc iNfft - S( ALL ,yE;� 6J4!,P&-/A'-7:5 A'Vz> /0014-- _��/�.�L-yr��� �i.%� !lf/GLu�E27 j� Prr�=✓i`o,.�.sz�.r I?.c�l�.+iv� �� ar lt�o2� New Electrical Meter, Second Electrical Meter (Affidavit required) FE 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 12 Pitch Total Sq. Ft of Construction: ZbDO Sq. Ft. of First Floor: Cost of Construction:$ 15-1969a �'' Utilities: —Sewer _Septic Building Height: I S`� r - _ - Name AnrN IZIs jj Name: rj/ Address: 5l�/®3 �yb�.�n}?Zics ''7jj :' Company:Cd*57`yNeitAc� ��Ot=�Nr� LZG- city: State,:A Address:-,7271 AVa Zip Code: 3�{��f - Fax. City: —er State: U Phone No. `772. 35-q S?g �t Zip Code: 3q-47,QZ Fax: E-Mail: Phone No '7'7Z. ZI& -9047 Fill in fee simple Title Holder on next page (if different E-Mail from the Owner listed above) State or County License�L��S'S�''7� /AQ2.9!J 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. 21 _N111 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 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 pr A Notice of Commencement must be recorded in the public records of St. Lucie County a ed on the obsite before the first inspection. If you intend to obtain financing, consult With, lend r a orne befo e commencing work or recording our Notice of Commencement. Signature of Own r/ or as Agent for Owner STATE OF FLORIDA COUNTY OF 1--A N �.o Sworn to(or affirmed)and subscribed before me of N,Physical Presence or Online Notarization this day of 20_ by Name of person making statement. Personally Known OR Produced Identification Typ�N Identification Produce Si to of Notary Public-State o lorida ) Commission No. (Seal) 3i9 ' s tNSHANNAINGRAM�PHMING W 40MMISBION O GG 275060 g• FWIRFA D1rAM4et 20,2022 Publlc Updwodters REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 5 2 21