HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Lieu i 7- , ►
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Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial Residential
CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: izcYqi aS itNttar`i �til- tj;tiLU
Property Tax ID #; 4s v H fir, ob i q & 0C
Lot No,
Site Plan Name: i&z.F14 L rL:- C,L Inls -hLL-
Block No.
Project Name: i„is ; f4LLr P VL FL:n{Lt
DETAILED DESCRIPTION OF WORK:
i�rrtifc►i=ice rxrs�� i� �fi�. = �'rn� 0ve<r Lkv*c-'1r 1=�,►�ri Wim
WA-LJ<_ f'A725- ,
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
Additional work to be performed under this permit -check all that apply:
_Mechanical
Electric
Gas Tank
Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ Z. ti Lin n ci c3
OWNER/LESSEE:
Gas Piping
— Sprinklers
_ Shutters
Generator
Sq. Ft. of First Floor:
Windows/Doors Pond
Roof Pitch
Utilities: _ Sewer _ Septic Building Height:
Name Cauk—rAic--/ 1XcL14L
Address: S T_,Canf fA 2c ��� isr�rvL
City: .ii_�5'L'N AC# State: FL
Zip Code: O -t 4 � 7 Fax:
Phone No. -1 17- S 7'7 E_
Mail: I&LE14i_C
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
Name: IA1+iw-u.tct 64iLZ 1i
Company: /A
Address: i ii,i 0476NLP# lst: u
City: PO—r S; Lu<_i.c State: t-1-
ZipCode: .7,49.6c, Fax: 7?,z 4og a2.-7-�-,
Phone No 772 !HtL - p223
E-Mail iPJF;6 IQ!i'Cf2�79rf=Lirl
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.
— -- -- -, ��-- .�. v�• nrrwvl l : Hppucation 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 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,
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 y ur property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and osted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an ttorn v before rrinn cin work or recording our Notice of Commencement.
Signature of Owner/Lesse�/Contractor a Agent for Owner
STATE OF FLORIDA `
COUNTY OF 5 i Liu ciL-
Sworn to (or affirmed) and subscribed before me of
this Q day of iJc v z rNif2L-L- 201k by
"khki CAC 35 i-+PL+:"(
Name of person makii tatement.
Personally Known OR Produced Identification
Ty pi�41 I d e nUUga#cia-Prod u ceTd
k Physical Presence or Online Notarization
(�ignaturI Notary Public- Stat4 of F to
Commission No. 2c5 (Seal)
Jr
40 State of Florida
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GG 929549
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SUPERVISOR PLANS VEGETATION
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DATE
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DATE
COMPLETED
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REVIEW REVIEW