HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X 7�
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
I?ROPOS'Ed) Il VMPROVEMENT LOCATION:
Address: 315 <— (ZA v-D P
Property Tax ID#:_ 1. g IDZ-®t7--000-i„ Lot No.
Site Plan Name: �,,��� "-\ (.t" _s Block No.
Project Name: , n �, i,-u.4S
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bN�c
CG,,�,-rieti-- ;Z(6- 10 1 i5, Sew ��rti
C-A l�A-"
4 ,3�
/�Ul�
CAJ4 (:00 2.
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit- check all that apply:
j Wechanical
Electric
_ Gas Tank
Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ L.A (, \ , 0-0
Gas Piping
Sprinklers
_ Shutters
(Affidavit required)
Windows/Doors _ Pond
Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
Address: 5 6 3�. — —•err r 0 Ly- .S`o
City: 'Fo r � V +' (' - c--e State: r
Zip Code: 314 ci Y -Z- Fax:
Phone No. `�_'t 2. _ `?S� Z G l v E-
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: i7f7r-9 �r
Company:
Address: 35 `�A W 0 c_ iycJl D t2 �
City: Q 0 w. 0 C,,A & 6 al State: L
Zip Code: 3:3 00 0'\ Fax:
Phone No'-Y-A Z---U �- — - 9 - a%
E-Mail cQ �,1 LehJA
State or County License 6,p 6-6 '1 Z
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.
S1.11��LE(U1��iNTA{L`C«NSTRUC�`IkON LfEN LAW JNFOaMATION <' "` `` � � �,� "`' '
DESIGNER/ENGINEER:
Not Applicable
MORTGAGE COMPANY: _
Not Applicable
Name:
Name:
Address:
City:
State:
Address:
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 ARFIDVIT: 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 ures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WA/It
G T OWN:yt
our failure to Record a Notice of Commencement may result in paying twice for
ove ents tr,iroperty. A Notice of Commencement must be recorded in the public records of St.
Co my $$ed on the jobsite before the first inspection, If you intend to obtain financing, consult
Ien er0 arneV nre commencine work or recordine vour Notice of Commencement.
e Lessee/Contractor as Agent for Owner
Si ofZORIDA
ST E OF
C NTY OF
Sworn to (or affirmed) and su scribed before me of — Physical Presence or Online Notarization
this ,,Zday of , 2 0 Z by
v
Name of person making tatement.
I Person ly Known OR Produ ed Identification
Type id ntificati Produced
Z',1
(Si nature of Notary Public- Sf to of Florida)
Commission No. (Seal) S93IAI89NMON104no1ltUpopwq �tp%a:10.
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REVIEWS
FRONT
ZONING .
SUPERVISOR
PLANS
VEGETATION
SEATURTLE .
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev S/LU/Ll