HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAII APPTICABTE INFO MUST BE COMPTETED FOR APPTICATION TO BE ACCEPTEDDate:Permit Number:Building Permit ApplicationPlonning ond Development SeNicesBuildinq ond Code Regulotion Division2jOO Viryinio Avenue, Fort Pietce FL j4982Phone: (7721 462-1553 Fax: (7721 462-7578CommercialResidentialCBDG FundingProperty Tax lD #:Site Plan Name:Lot uo.1\- 85BlockNo.Project Name:New Electrical Meter_ Second Electrical Meter(Affidavit required)Additional work to be performed under this permit - check all that apply:_Mechanical _ Gas Tank_ Gas Piping _ Shutters_ Windows/Doors _ Pond_ Roof _ PitchElectric_ Plumbing _ SprinklersGeneratorTotal Sq. Ft of Construction:Sq. Ft. of First Floor:cost of construction, S 5 ,1S5. l-'Utilities: _Sewer _ Septic Building Height:lf value of construdion is ZSOO or more, a RECORDED Notice of Commencement is required-PERMIT APPLICATION FOR:PROPOSED IM PROVEMENT LOCATION :Address: IDETAILED DESCRIPTION OF WORK:CONSTRUCNON INFORMATION :OWNER/LESSEE:CONTRACTOR:city: 6v{ gror ccZip code: ?\ 15 \ rax:Phone No. St I. G'\U.\5o? E-Mail:Fill in fee simple fide Holder on next page (if differertfrom the Owner listed above)Name ateven S\Lb rheaaress, 21n1 6c-nt ?rnc 0r.State: -QLState: FLzipcode:?Qltit Fa*:-liE-.S!4.L3g-3_t_Phone NoE-MailState or County Licenselfvalue of HAVC is $7,500 or more, a REcoRDtD Notice of Commencement is required.I
LIEN LAW INFORMATION:zip: 33L oi PhoneMORTGAGE COMPANY: X Not ApplicableName:Address:City:State:Zip: _ PhoneFEE SIMPLE TITIE HOIDER: _XNot ApplicableName:Address;City:zip:Phone:BoNDING COMPANY: _[Not ApOlicableName: _Address;City:Zip: _ Phone:OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.I certify that no work or installation has commenced prior to the issuance of a permit.St. Lucie Countv makes no reoresentation that is rrantins a oermit will authorize the Dermit holder to build the subied structurewhich conflicts with anv aoplicable Homeownersassocia,-tioh rules. bvlaws or and covenants that mav restrict or or6hibit suchstrudure. PIease consult \i,ith your Homeowners Association and ieview your deed for any restrictioris which may apply.ln consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the workin accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.The following building permit applications a.e exempt from undergoing a fullconcurrency review: room additions,accessory structures, swimminS pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use- or - owner Builder as applicableSTATE OF FLORIDACOUNTYOF a Loie-Sworn to (or affirmed) and subscribed before me ofthis 2j day of *Lritr .2o[byllehysical eresence or - online Notarizationof Notary Public- State of Florida)commission No. blqqq (seat)Name of person making statement..:','...1 : FERNAI\DO EiTAN(CUBTr:.ts.x.l. Nota,v pubtc - Star€ of Florda'"itij' *,'."*l'i:;;:ii,'il:$ 11Eondad through llational Notary Astn'III