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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
L U ALL
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 3498.2
Phone: (772) 462-1553 Fax: (772) 462-1578 CRDG Funding
i PERMIT APPLICATION FOR: fk r , r� a
PROPOSED IMPROVEMENT LOCATION: G
Address:1'3c=C Z 4j Ok
Property Tax ID #: - : � J cloo -- O Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Rc I+ .S-zi)d - 2 5A FL vZC,69
New Electrical Meter Second Electrical Meter
i CONSTRUCTION INFORMATION:
111.,2 - $-�/ 33I0-rTJ-2,
(Affidavit required)
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 !2 Pitch
Total Sq. Ft of Construction: L *75 Sq. Ft. of First Floor: / �n '7-S �s
Cost of Construction: $ ��77 v , 0 "O1' Utilities: _ Sewer _Septic Building Height: /-
J
OWNER/LESSEE: I CONTRACTOR:
Name[_'1(.s al'1(��l i Name: ( t-� 14,
Wfir,
Address: ' JJ 0o Company:
City: r- )r4 pll le. State: Address: ?A�) 11 LS
Zip Code: SjG U`Fax: City: State: -
Phone No. ` --): o�`�'�' ! 3`7 _ E- Zip Code:---Qq�� Fax:
Mail: I Phone N-a1�'�- 13--7
Fill in fee simple Title Holder on next page (if different E-Mail Vdw, 16 `7-1a), 0 oAY4, -cum
from the Owner listed above) State or County License Cc(
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL. CONSTRUCTION LIEN LAW INFORMATION:
DESiGNERIENGIJNEER: � plot Applicable
Name-
Address:
City: State:
Zip. Phone
FEE SIMPLE TITLEHOLDER: Not ApOicable
Name:
Address:
City:
Lsp: r E loi te:
MORTGAGE COMPANY: - Not Applicable
Name: --
Address:
fcy. State:
Zip: Phone:
BONDING COMPANY:
Name:
Address_
City:
_-.Not Applicable
OWNER! CON7RACTOR Aii-FIDW1: Application is hereby made ;o obtain a permit to do the work and installation as indicated.
I certify that no work or installation has cornmenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit wiii authorize the permit holder tv. build the subject structure
which confikts with any applicable Homeowners Associa ion rules, bylaws or and covenants that may restrict or nrohlbit such
structure. Please consult uEth your Homeowners A.ssodation and sevievr you., deed for any restrictions which may apply,
In consideration of the Granting of this rwnttPSts,E{ permit, k dcn hereby agree that L will it all respects, perform tw rp
in acearciarte with the approved plans, the Florida Building Codes and St. Lucie. Counti,a y Amendments.
The following buiiaing 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 to Record a Notice of Commencement may result in paying twice for
improvernents to ur roperty, A. Notice of CorTmi'i encernnent must be recorded in the public records of St.
Lucie County a€ o e ors the ° to before the first inspection. If you intend to obtain financing, consult
with lerlr J�ey b re�co..mencEnQ �unrlE !3t rprC?rllsrll7 Vr111r Nntirg of f nrrtisnarse mm�nt
S*15atuKof Owner/ L# � 4 ntract©r as Agent for Owner
STATE OF FLORIDA
COUNTY aP _ cAC
l
Sworn to (or affirmedi and subscribed before me of V Physical Presence or online }Notarization i
this ,.day of j2t'�(e-_` 20,_�.i by
Name of person rna;kift statement.
I Personally Known OR Produced Identification
Type of identification Produce
I (Slgna.urC ct fVataryPublic- Scab of f'�orid�
� f
commiss'ranfro. (Seat) '<'•�"�a4. A391ANAXkVA
Nmrf %,clic 5taze : �torid� �� -� Consmission r GG 9�n�2S
I p
oxfi,
MY COMM. Exoi+es Nov i, 2013
REVIEWS
FRONT I Z©NING
SUPERVISOR
I F
� PLANS � VEGETATION � SEATl MANGROVE
COUNTER I REVIEW
s REViEW
REVIEW I REVIEW i REVIEW REVIEW
DATE
i RECE VED
DATE
COMPLETED
� I
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