HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE !NF{] MUST BE COMPLETED FAR APPLICATION TO BE ACCEPTED
Date;
Permit lUtin1bC'.f
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Building Permit Application
Planning find Developolcot Service.5
RU i Liding and Code Reg ul don 0� . vi Sion
2300 Virolmo Avenae, Fort Pierce FL.34982
Phone: (772) -1 Fax-, (772) -1 7
Commercial.—
CBDG Funding
PERMIT APPLICATION FOR: CA,(�
j PROPOSED IMPROVEMENT LOCATION:
Property Tax ID tt: ' `.� 1-i '..C�)'CYvL&X---
S
IL P P I a n Name F
P ro j e c t N a m e b
Residential
Lot N,
Block No,
DETAILED DESCRIPTION OF WORK... . ...... ..........
-L
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New Electrical Meter _�.. Second Electrical Meter ._ (Affidavit required)
....... ... ... .... ..
CONSTRUCTION INFORMATIONr
Additi onaIwork t er-f o rrric2d u nder th i s pe rrinit— check -aII thatap ply :
X. mechanical l zis Tan _ Gas Piping ShUtters
Electric
l�rr-ribiri
ot l sq., art of Construction: --
Cost of Construction:
� OWNER/LESSEE:
Sprinklers
utllitle5l
Name &kr_:Y:::1 E�
---
` '
Address:
City. State:
71P code: F Phonp No. Au Lo _
1 "AUIA�o
Mail. V)ff)ZMffi
Fill in fee simpleTitle Holder on next page (if different
from the Owner listed above)
Generator
. Ft, of First Floor:
Sewer
windows/Door's ..__ Porici
Roof Pitch
Septic 611ding Height -
CONTRACTOR:
R o r npa ny: � �
1d z
E- Zip de: �),A
Phone o 2. 1K ?)
W�
-Mai I
State or County License.
If,value 1ue of construction is 2500 or more, a RECORDED Notice of Commencement is required.
'If value of HAVC Is 57,500 or more, a RECORDED Notice of Commencement i 5 required.
State:
Fax.
( - I P.. � r6ACYA " * i
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION.,
❑E51GN�R/�N�INEER:.�. Not11Eaplicahle T
Name:
Acldr@55'
Zip:.._._..._ I
MORTGAGE P Not Applicable
Name:
dr.
City: State:
Z i P: Phone,
FEE SIMPLE TITLE HOLDER,- Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: — ---(pity ---... -
---
Lip, Phony: Zip: Phone:
QWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to Qbiain a pernitt to do the work Jrtid installation as ind1cated,
certify that no work or installation hay commenced prior to the issuance of a permit.
t. Lucie County makes no representation that is grallting a permit will auth o(izv the permit holder to btjild the s( 1iject structure
Nch conflicts with any applicableHomeowners er Ci tron rules, bylaws or and covenants that may restrict or prohibit such
�trt, r to re. Please consult with your Homeowners Association Arid revsew your deed four any restrictions which m aapply.
I ro n fd ration of the granting rat inn of this req U esLed permit, I d he re b agree that i ill, ' n all rs ct ', p rf r 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 conWrrency review, room id it i ns,
accessory structures, sari rn mi ng pools, fens r walls, !i ns, screen rooms arid aCCE,ssory uses to in of h ei r)oti -residential use
WARNING I To OWNER: Your failure to Record a Notice of Commeiicement may result in paying twice for
improvements to your property. A Notice of Commencement Welt be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obt Nri finaricifig., coiisult
with lender or are attorney before commeincing work or recording your Notice of Conimencemetit.
t
. e4 q ,
Signature of Owner/ Lessee/Contractor as Agent for Owner
M
STATE OF FLORIDA
COUNTY OF
Sworn to (or ff Wined) an -subs .ribed before me of
•'h
this day of �. #_ � �.� }_ '�.�._� 0 b
Name of persor) Making statement.
Personally K roc wti � OR Produced Identification
Type of id nt' ]cation Proci ii ced �
* II-n4l 40 comi mw# H H 055167
jSignaLure of N'Ffor k#v
(irnmissi n No.
REVIEWS
DATE
EFIF
DATE
. FILE-1• 11
1 5120/2
"w.a nw &dy# N.y,y s.erk.a
m ___ _( 'aI)
FRONT ZONING
COUNTER REVIEW
i
SUPERVISOR
R EV 1 EW
PIS 51cal Presence or Online Notarization
PLANS
REVIEW
vEcEraTioN
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW