HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAII APPTICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:l7-7 -2t io.*fr #
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Permit Number:
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Lrli Building Permit Application
Plonning and Development Services
Building ond Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-L553 Fax: {772l. 462-L578
Commercial Residential
CBDG Funding
Address:5. bern 0.Teosen (kL /7rzt/fll -.1 2 -oo&gProperty Tax ID #:
Site Plan Name:
Lot No
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Project Name:
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New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION I N FORMATION :
Additional work to be performed under this permit - check all that apply:
_Mechanical * Gas Tank _ Gas Piping _ Shutters _ Windows/Doors Pond
Pitch_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof
Total Sq. Ft of Construction:Sq. Ft. of First Floor ?yd
Cost of Construction; $lJ OC-ua Utilities:t'S"*". - Septic Building Height:7fy
lf value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
lf value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
PERM IT APPLICATION FOR:D"rol; f;on
PROPOSED I MPROVEMENT LOCATION :
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OWNER/LESSEE CONTRACTOR:
vAddress:
City:State: fu
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Fiu in fee simpre rirl. rJo"[iKffi (if different
from the Owner listed abovel
Name
Cornpany:
Address:€PT
City 4 starc: Fd.
Zip Code:
Phone No
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E-Mail
State or County Lice c n
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DETAILED DESCRIPTION OF WORK:
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Zip code: 3-{q { 7 Fax:
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Phone Nr. tlll j' 7.2d - i ldT
ENTAL CONSTRUCTION LIEN LAW INFORMATION:
MORTGAGE COM
Name:
Ad
Pzip:
City:
Address
DESIGN
Name:
_ Not Applicable
zip:Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
7ip:
Applicable
Phone:
G COMPANY:_Not Applicable
Phonezip
Name
Address:
City:
OWNER/ CONTRACTOR AFFIDVIT: lpplication 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 Countv makes no representation that is srantins a permit will authorize the oermit holder to build the subiect structure
which conflicts with anv applicable Homeowners-AssociJtioh rules, bvlaws or and covenants that mav restrict or prbhibit such
structure. Please consult With your Homeowners Association and feview your deed for any restrictions which may apply.
ln consideration of the granting of this requested permit, I do hereby agree that twill, 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 re the first inspection. lf you intend to obtain financing, consult
with lender befo enci or r Notice of mme ent.EL\
4-
of Contractor er Builder as applicabler-
STATE OF
cou NW OF
Sworn to (or affirmed) and subscribed before me of
this GPiday of Ee-Cf r,"-hgz- 20 J-lby
A dur^ 5.r',.i4l,"*,
Physical Presence or _ Online Notarization
Name of person making statement.
Personally Known OR Produced ldentification uf { t
Type of tdentification proTuced 1=t n ,-; r( ^ f) [
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commission No.l#[Qfigs9L$",tt
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REVIEWS FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED