HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: _ ZPermit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
_
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: CZ
PROPOSED IMPRO EMENT LOCATION:
Address: gY _0_,5__Fzk-Y-
Property Tax ID #: _ C . �/ r.-�,Q,P�i�"%� �0 Lot No. 11- 12
Site Plan Name: irk__ �_ __ __ ___ Block No.
Project Name:
I DETAILED DESCRIPtION OF WORK: i
New Electrical Meter XSecond Electrical Meter._____ (Affidavit required)
[CONSTRUCTION INFORMATION:
Additional work to be performed under this permit - check all that apply:
�.Mechanicai Gas Tank ^ Gas Piping Shutters — Windows/Doors _ _ Pond
XElectric Plumbing Sprinklers Generator —_ Roof Pitch
Total Sq. Ft of Construction: _ _ Sq. Ft. of First Floor:
Cost of Construction: $ _ �w�s �>D—� Utilities: .—Sewer —Septic Building Height:
i OWNERJLES5EE: _
CONTRACTOR:-
Name_..._ .!�-� �
Name: MF..AQ
_�3AYDdC)N
Company: LSCI INC.
Address: _�
Address:
;Address: _Z300 E3R.YAN_l),t RM R_ D 5�11TE 4QQ_ _.
City:. /�(-__...-_.._ . .... ..._.. 5tate:..t«�
Zip Code: - �.IFax:
'City: _-SEMINOLE State: FL
_ _
Phone No. -%-) Q ��' i�-� Ll -7 Z _�_ E
_
' Zip Code: 33777 Fax: 727-683-9854
.A' y (� D /�r
Mail:. U ' C� _�
Phone No 727-571-4141 j
E-Mail armitg(&gu _ teCsola3[energy.CQjn
Fill in fee simple Title Holder on next page (if different
from the Owner listed ab ve)
State or County License CVC056656
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If value of construction Is 25 0 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.
S PPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
j DESIGNER/ENGINEER: _ Not Applicable--�T— —
MORTGAGE COMPANY:
i Not Applicable
Name: LORD & LAVVRENCE CONSULTING I Name:
Address: 5700 LAKE'NORTH RE) I ---
Address:
City: -GREENACRES State: FL City;`
+ State.
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Zip: 33463 Ph 5st-aaa-s192
Phone'
i 4 Zip: Phone: f
FEE SIMPLE TITLE HO DER: Not Applicable I BONDING COMPANY: Applicable —~
_Not
Name: Name:
Address: i Address: I
City: _ _ '. City:
Zip:_ Ph
ne: Zip: _ Phone:
OWNER/ CONTRACTOO AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or ins > Ilation 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 ap Ilcable Homeowners Association rules, bylaws or and covenants that may restrict or
prohibit such
structure. Please consult wi .h 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 apprbved 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, swirnnlling 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 attorney before commencing work or recording your Notice of Commencement.
1 Signature of Owner/ Lesseo/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF ST. LUCIE
Sworn to/or affirrper+r ;indlsubscribed before me of Physical Presence or Online Notarization
i
i
i
j Name of person making statement.
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Personally Known X OR Produced Identification 'o.rsy'ei Notary Public State or Florida
Frank M Perry Jr
Typ o I ific n Produced-.. --•— -- C« My Commission GG 336129 i
'i Expires 05/28/2023
I
(SigAzituri of Nolid Public- State of Florida)
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Commission No. (Seal)
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i REVIEWS FRONT
; ZONING SUPERVISOR, PLANS I VEGETATION SEA TURTLE MANGROVE
COUNTE!,::
REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW ;
j DATE J
RECEIVED
DATE
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COMPLETED
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