HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE I FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: Permit Number: v
01
C.ucllLS�ud�e CO9
Building Perm it•Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
Address: 1,706 AW Wlsvr6ieg rieeae Qp
Property Tax I D#: �y2 �— ?Q/��QQ f�— �0-� Lot No.
Site Plan Name: Block No.
Project Name:
1VrEW Eleyarog Dar C ShaFr AFIQe4rok E/AerrIC Lillwk 1P1uw+61Au6
CONC2eiG d A7�SOA//d 4Tit/' A��w Gu�waDtU e Shed(wI
New Electrical Meter Second Electrical Meter (Affidavit required)
I
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank Gas Piping _Shutters -,fV Windows/Doors _Pond
Electric _elumbing —Sprinklers _Generator _X Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of'First Floor:
Cost of Construction:$ ySO. ODD. .p Utilities: —Sewer —Septic Building Height:
'. 7EP _ _
.:
Name ThQeO ore L. W 6)SC Name: Jer-ace L VsQ.Lty
Address: 2 Q / ,C company: artlege ( Sr4lT _V-1(1C.
City: Pa/ c State:_! Address: /227/ CPS S&A Terrae g
Zip Code: 3 q Fax: City: PrT s-r. (,uC/Q State: 4C
Phone No. Zip Code: 3(19 97 .Fax:
E-Mail: Phone No
Fill in fee simple Title Holder on next page {if different E-Mail
from the Owner listed above) State or County License L"C 4036926 9 —
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.
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: 4V OJVNy lwlei Name:
Address:_/3 /2 9to 2 9 3(j Q T• Address:
City: ,,# State:-FL City: State:
Zip: 3 3 17 8 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 an restrictions which may3,. apply.
.. -
In consideration of the granting of this requested permit, I do hereby agree that 1 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 property. A Notice of Commencement must be recorded in the public records of St.
Lucie,Co.unty-and;posted,on the jobsite•before the first.inspection. If you intend to obtain financing, consult
with.lender Of an attorney before commehc' ifl wo k'o recording• our Notice`of Commencement:
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ignature er/ essee/ ntre oras Agentf r ner
STATE OF FLORIDA
COUNTY OF
Swo (or affirmed) and subscribed before me of hysical Presence or Online Notarization
this day of 26 by
Name of person making statement.
L Personally Known OR Produced IdentificationDC-,'
Type of IdentificatigmPrroduuced
(Signature of Notary Public-State o orida)
Commission No. �. ELLEN VAUGHN
ar State of Florida-Notary Public
*_'"Commission ti-GG 270079
i9! ��
- E IYI C o � Commission
_ s si ,OFFS Y on Expires
nrtnhar 7? 9097
REVIEWS FRONT ZONING :SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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