HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
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Building Permit Application
Planning and Development Services
Building and Lode Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: 'V,C —IF-OOP
PROPOSED IMPROVEMENT LOCATION:
Address: ZIOItt SENEG,+ 4VE4Ue 1 _FOp'f PieV-cE, Fi- 3�`lip
Property Tax ID #: 14 2-0 - i02' 1012 - 000 -04 Lot No.
Site Plan Name: Block No.
Project Name: zN eRG L-y E ✓
DETAILED DESCRIPTION OF WORK:
R-E_ - PCOF OF ftME Fzbo !E75M N rrt
Zip 0—,A• FL 3Ito52- R1-
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
META-L-
(Affidavit required)
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Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters —Windows/Doors _ Pond
Electric _ Plumbing _ Sprinklers _ Generator ✓ Roof Pitch
Total Sq. Ft of Construction: 7-1 1P9 3 Sq. Ft. of First Floor: 2-1 (O 1 3
Cost of Construction: $ 15,500 Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name AWMN 7-K-9-6 L-YE
Name: MJIeAL-E
06A,l"
Address:
Company:AUI6940
cWWIfiIf 4XF
City:2(plq SEWVe SAVE FWr PIEX&State: W
Zip Code: 34982 Fax:
Phone No. 305'(al5"9'{I E-
Addre i 15 NW eVTI- -1S�TVa►'C—
City: T A?-T Sr Val E7 State: F'L-
Zip Code: 1841 Fax:
Phone No %%Z-Lfq2-800fo
Mail: 0iZhCrCIVCVl@ArA61•COw1
r
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail
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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.
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City:
State:
Zip: 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 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 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 attornev before commencine work or recordine vour Notice of Commencement.
Sign re of Cont or - or - Owner Builder as applicable
ST ORIDA�T WCAC
11
COUNTY OF
Sworn to Jor affirmed) ands bscribed before me of _ Physical Presence or _ Online Notarization
I of -C" 2024 by
Name of person making statement.
Personally Known ` OR Produced Identification
Type dentific tion P oduced
;?14 h�'D1.r�
(Signature(6f Notary Public- tate of Florida)
.z ELIZABETH A. SCILER
Commission No v (Seal)
* No[ary Public, Sure Of Florida
Commission No. HH74732
%'.";eMy Commission Expires: 12 /2212024
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Kiev w/12/21