HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2A4 N Permit Number:
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Is � - `" 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
PERMIT APPLICATION FOR; ��L(C��� "��,.- n\• y,��
PROPOSED IMPROVEMENT LOCATION:'
Address:�2\
Property Tax ID #: Lot No.
Site Plan Name:
Block No.
Project NamP> L �r-'J'
ESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter
,PNSTRUCTION INFORMATION:
Additional work to be performed under this permit - check all that apply: ��
Mechanical _ Gas Tank —Gas Piping p
_ Shutters \Windows/Doors _ Pond
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ �� �uJ Utilities: _ Sewer —Septic Building Height:
— - -_ -- --CONTRACTOR: T
i OWNER/LESSEE:
Name �)CvYI��
Address:Lo2\ 5F_-tS'&Aee-, _QAuC!
City: �l- State: P�
Zip Code: ,G,��� Fax:
Phone No. 2-SZ -SGC->l \
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name:
Company��� i
Address:e�5--13'->
City: State: p
Zip Code: Fax:
Phone No17)F ' 3�5_0 S
E-Mail r aySef
State o o y Lice e"7FS��
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.
NSTRUCTI-UN LIEN LAIN INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:_
Address:
City: _
Zip:
Phone
State
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:_
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: ,% _ Phone:
Not Applicable
State:
DING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRAC AFFIDVIT�Ap lication is hereby made to obtain a permit to do the work and installation as mcitcar.eo.
I certify that no w or installation has encedprior 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
of St.
improvements to your d on th jobsltelce of before the first inspect on. ifent must be recorded in the you tend to obtain financing,ublic consult
Lucie County and posted on the
..,;�" 14�r nr an attnrnPv before commencing work or recording our Notice of Commencement.
Signature of owner
ntractcr as Agent for owner
STATE OF FLOR STATE OF FLORIY,! � + �
COUNTY OF�� �= COUNTY OF �ti
,,_�rn to (or affirmed) and subscribed before me of
p� ystcal Pr.en-ce or Online Notarization
this 1L day of ` a� � by
Name of person making statement.
'personal � �,
T e of Identification aP Notary Public state �r Fonda
YP Ashley Del Toro
Produced ^ rssion HH 052369
''►OF Expires 1Citi2024
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i
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
n to ;or affirmed) and subscribed before me of
Physical Presence or OnlineN,yotarization
,,,
this ?iday 0 r G by
Name of person making statement.
Personall Kn
Type of Identification .►�"w'votary Public State of Florida
Produced Ashle Del Toro
.y . , y ommrsston HH 052369
Expires,a,iao2a
/�
(Signature of Notary ublic- State of Florida )
Commission No. _ (Seal)
PLANS VEGETATION SEATURTLE MANGROVE
REVIEW
REVIEW REVIEW REVIEW