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HomeMy WebLinkAboutSelph building permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date* Permit Number: �N Noe j! Building Permit Application Panning 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 PERMIT APPLICATION FOR: PROPOSED IMPROVEMENT.LOCATION, Address: (:,.k \C Property Tax ID© -tab C) Lot N Site Plan Name: Block Project Name: /�-o 0 .DETAILED DESCRIPTION OF WORK' 4ek I Id /Y c W New Electrical Meter---- Second Electrical Meter [CONSTRUCTION INFORMATIONi -Y;q- Call 96 40, 1�3' wjkx Additional work to be performed under this permit— check all that apply: —Mechanical Gas Tank Gas Piping Shutters windows/Doors Pond Electric /D]Will k*1.6 - - Sprinklers Generator Roof Pitch Total Sq. Ft of Construction:.--..-,------ Sq. Ft. of First Floor: Cost of Construction: $ J� a Utilities: —Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: N a m e-sb ---pn "�%6--, Name: ;17 Company: 47r Address:Q -� �nn -Izr\�-OcLd al f City: a Vie-K5- State: °� S �4c Zip Code, P46 — Fax:— Phone No--11�- Address: 3711 5-w sg,,�jl ?0111Cr City. , 110 - Stale: & .. Zip Code: Fax: , Phone No 7?Y� E-Maii: Fill in fee simple Title Holder an next page (if different from the owner listed above) State or County License C4C.lq If value of construction is 2500or more, a RECORDER Notice at Commencement is requires. if value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTIC3N LIEM, LAW lNF©RI1/iATtQN� DESIGNER/ENGINEER: _ Not Applicable Name. MORTGAGE COMPANY: _ Not Applicable Name. Address: Address: City: State: Zip; Phone City: State: Zip: Phone: FEE SIMPL-TITLEHOLDER: — Not Applicable Name: BONDING COMPANY: Not Applicable Name: Address: Address: City: j Zip: Phone: city: Zip: Phone: vevtvtf I c.vry t KAIL-I IIJK AFFIOViT: 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 conturrency 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 rommenrina S' tore of Owner essee%Contractor as Agent for owner Sign ure of contractor/License Holder STATE OF FLORID COUNTY OF STATE OF FLORID COUNTY OF'".�"� Swop to (or affirmed) and subscribed before me of Ph �+si�cal Pres rice or online Not rization this c6` i�ay of - 'y orn to (or affirmed) and subscribed before me of Physical Presence or online Notarization this � day of (/DVGbt 2020 by �cJ�'�_ Cct"-c Name of person making state'lnent. Personally Known OR Produced Identification Type of identification Produc d -;1'0 Name of person making statement. Personally Known le OR Produced Identification Type of Identification Produced _ �_ �-lA. Public- S Qf Elorida S ature of Notary Public- St f i a ) , y y��A�,xt=�y�� l'11G'i C. ✓ i Y "4iq CA €iGi'[TX4S E j commission No.e�**ft#GG26M Commis 'on No. Putft Stall Fkxi -w� 3¢.._.. ? —s 2T. . f8p !I@Z MY Comm wm GG 93777 REVIEWS FRONT COUNTER VEGETATION REVIEW S REVIEW REVIEW ZONING REVIEW SUPERVISOR REVIEW PLAINS REVIEW DATE RECEIVED DATE T--..--------1.,.___ CCIMPLETED I I ev.