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HomeMy WebLinkAboutBuilding permit appAll APPUCA LE IN O MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED � Ito W 03 Date: Permit Number: �O � � ac Building Permit Application °`�\... QI °° Planning and Development Services ez�W u ingaintianeivrsian�^ rnrsi ntlal - 2300 Virginia Avenue, fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR; Q Y Address: Property Tax ID #: O )0Lot Ffo. c Site Plan Name: �y /yy /�t ` Block No. —�,— Project Name 4f.LCQ-'`� C.VU/ Y tD C h k u9 ilY S t P Z+ G }5 J 4 tr L t;i 4 J£X'^ Spy z,SI r �-'i. £✓N xy�."£..tx '.r}: a New Electrical Meter Second Electrical Meter �.1 ('}r^4 (rgyxpp i�N 0FILI tk rrxh 19 Jg 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: �I Sq. Ft. of First floor. _r�� j r� �, Cost of Constructions $ Utilities; -Sewer _Septic Building Height: t � +r met a�. { t£, Mad' .. z, .,9. Name Name: Addre i% i �I Company: r City: State: Address:_ _ Zip Cade: _ Fax: City: State; C Phone N CZip Code: fax: Phone E-Mail: Phone No Fill in fee simple Title Holder an next pa a (if different E-Mall b % e C ej it Ny1� arz . from the Owner listed above) State or County License nh if value of Construction is,2500 or more, a RECORDED Notice of Commencement is required, It value of HAVC is $7,500 or more, a RECORDED Notice of Commencementis required. ??{"tilr'nttA�'t1ki+CMy!'1��'p,'MrY.S DESIGNER{ENGINEER. Not Appitcabie MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: State. City: State: City: Zip: Phone Zip: Phone: FEE SIMPLE TITLEHOLDER: _ 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 todo the work andmstallanon as I certify that no work or installation has commenced prior to the issuance of a permit; . . .____ ---------- G_., n+;neon..it.111mthnrizethe oermitholder tobuild the subject str structure. please consult With your Homeowners Association and review 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 improvements to your propert Lucie County and posted on the L �L� L-n.a.retir,a umar in paying twice for ad in the public records of St. d to obtain financing, consult of Commencement. With ienoer or an acc©rnC YCI VI C 4111 OL G „ vw n v. . r--. -,.. SignatureofOwn seejContractorasAgent for Owner STATE OF FLORID / t��� COUNTY OF Swo n to (or affir ed) and ubscribed beip a me of ysical Presence or_ online Notarization this��.,tlay 2p�_,.�.-hY (V� \ Name of person making sta ent.. Personally Known OR Produced Identification Type of IderRification Produced... (Signature of Notary Public- State of Florida T o R i G r (; v� Sttt 0� rl(Sridd (14nla�Y=>�, y Commission No.0 � Seal( �� car:, s� n, p G aoUtss� Meou;rr s6�an „arutc REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 5/zu/zl