HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONS.—
All APPLICABLE INFO ST BE OMPLETED FOR APPLICATION TO BE ACCEPTED 1 �i
Date: Permit Number5z>�`
tt �2 2-
9V. IL RECEIVED
Building Permit Application OCT 2120
Planning and Development Services St. Lucie unty
Building and Code Regulation Division Commercial ReSidentialPermi ing
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED P OVEMENT LOCATION:
Address: t6
Property Tax ID #: 4QC r Lot No.
Site Plan Name:
Project Name:
New Electrical Meter
CONSTRUCTION INFORMATION:
Block No.
Additi work to be performed under this permit —check all that apply:
—Mec ical _ Gass Tank — Gas Piping — Shutters _ Windows rs _ Pond
Eli' ectric It�P umbing p _ Sprinklers Generator _ Roof Pitch
—
Total Sq. Ft of Construction: Sq. Ft. of First Floor: ���
Cost of Construction: $ Utilities: — Sewer — Septic Building Height:
OWNER/LESSEE:
CONTR OR:
Nam AVt
Name: /
Addr rrn a,0,
Company:
Cit Stat
Addres /'22 1 s2
Zip Code: Fax:
Ci I State:
Phone No. E-
Zip Code: ax: �—
Mail: 1 i .
Phone No '—
Fill in fee simpl itle Holder on next page (if different
E-Mail
from the Ow er ted above)
State or County Lie se
If value of constr�Eion 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 LIENLAW INFORMATION:
DESI /ENGI R• Not Applicable MORT
Name: Name:
Addre s Addre:
City State.(/ City:
Zip: Phone Zip: a
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING CO Pi
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: P
JWNER/ CONTRACTOR AFFIDVIT: Annlication is herebv made to obtain a nermit to do
I certify that no work or installation has commenced prior to the issuance of a permit.
_Not Applicable
work and installation as indicated
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 struct , ' ming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARN TO OWNER: ur failure to Record a Notice of Commencement may result in paying twice for
provements to you ropepty. A Notice of Commencement must be recorded in the public records of St.
ucie County and po ec i Pe jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an torn v IYefore commencing work or recording our Notice of Commencement.
Signature of r/ Lesse
gent for owner
STATE OF FLORID
Tfa
COUNTY OF
SwoM to
before P� Presence Online Notarization
(or aflfirmed an
subscribed me of or
thday of
2@aay
Name of person making statemenC
rsonally Kno
OR Produced Identification
T entification Pro uced
(Signature of Not ry Publi
Notary Public State of Florida
Commission No.
( 'V!e rle A Barber
9Ny Commission GG 926292
or w Expires 10127t2023
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