HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
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P64
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial
CBDG Funding
PERMIT APPLICATION FOR: VC
PROPOSED IMPROVEMENT LOCATION:
Residential
Address: JyO L � Mk 6 j 6a 44 .5-- �� f I' P�'CP .3 �1- 10
Property Tax ID #: `, 6 - 7 ( U '0 0/-5- — pp - y Lot No.
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Site Plan Name: ,Dlt SS-e Block Nosd
Project Name:
ETAILED DESCRIPTION OF WORK: '
os
hrw fi .� +-litovlS o'�(t SI P pYc)�P- h-e f D6vy J r � of � s )J t
VD i Vt 3 �.
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
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:
Cost of Construction: $ a
OWNER/LESSEE:
Name h/j_
Sq. Ft. of First Floor: _
Utilities: —Sewer —Septic
City: :F_U ✓ State-FC
Zip Code: qg Fax: Ck
Phone No d _ 7
Mail:.-4
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Building Height:
CONTRACTOR
Name: YDPU-�� yv�Gt,V�
_ Company: vl LQ
Address: 40 52� S
City: State: �L
E- Zip Code,3q 18- 3 Fax:
Phone No -179 - .3 LID -7,3k-Li 7
E-Mail ClLa p►v►Q11 e!/1Ge IIIC.
State or County License
If v�- a of construction is 2500 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
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 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 County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with 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 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 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
WithlZnFttgr or an attornev before rnmmanrina,e,nrie nr rornr.a;..rr ,,—, nln+;, ,.0 r, _.
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Signature of Contractor - o - ner Bui1 era applicable
STATE OF FLORIDA
COUNTY OF li
Sworn o (or affirmed) nd subscribed before me of v Physical Presence or Online Notarization
this day of 20z- 7--by
Name of person making statement.
Personally Known \/-' OR Produced Identification
Type of Identification Produced
(Signature of Noltallry\ Public- State of Florida)
Commission No.`fl.�l2' ��(Sea YP..
oil qe,, NANCY J SHEA
.07�: Notary Public - State of Florida
Commission # HH 209355
oFr,° My Comm. Expires Dec 19, 2025
Bonded through National Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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