HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COKAPLETED FOR APPLICATION TO BE ACCEPTED I
Date-. Permit Number. C
L la, uL
... RECEIVED
IV *0 L" ` Building Permit Application DEC 13 202t
Bloaning and Devefopment Services St. Lucl2(�o
Building and Code Regufation Division Commercial Residential per 9
2300 V rginio Avenue, Fort fierce Ft 34982
Phone, (772) 462-1553 Fax: (772) 467-1578
PERMITAPPLI ATION FOR: —
�� — ----------_. .. ..---- T
PROPOSED IMPROVE ENT LOCATION,— ..
Address; i. e-
PropertyTax Ib #: ...) , - ' Ono ' 3 Lot No.
Site Plan Name: e-I tz:, Block No,
Pfoject Narne: _.
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter- (Affidavit required)
Additional work to be performed under this permit-check all that apply:
Mechanical Gas Tank r )Gar' Piping —Shutters Z'Zw indows/Doors Pond
1 lectric A"Plumbing —Sprinklers Generator 140of Pitch
Total Sq. Ft of Construction: � Sq, Ft of Fiat Floor:
Cost of Construction; r"ICJ* c Utilities: —Sewer _Septic Building Height:
,l
Name Name.
,Address: Cornpany: Y-e 4 �
City: State:Fj Addre55_ )35I1 L CatI" -.--
Zip&de3U --I5_ Fax: City: !Cc Y k'-a+rl Stater
Phone Na l Zip Code: L49 �_ Fax,
E-f+llail:(2A'-"r b Y Phone No � -1 �Lo _
Fill in fee simple Title Holder on next page if different E-Mail _
from the Owner listed above) State or County License_ .C: ` W Z r
If value of cvnstructian i5 M0 or mare, a RECORDED Notl[e of Commencement is required.
If value of HAVC is$7,5DO or mare, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION, j
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name,
Address: Address:
City: State: City: State:
zip. Phone zip: Phone:
FEE SIMPLE TITLE BOLDER: Not Applicable BON DING CO TM PANY: —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 instaI tat ion as indicated:
1 certify that no work or installation has commenced prior to the issuance of a permit-
St. Lucie County makes no representation that ' granting a permit will authorize the permit holder to built!the subject structure
which conflicts with an applicable Hameowners Association rules,#�ylaws or and covenants that may restrict or prohibit such
structure: Please consuyt 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 arQ exempt from undefgoing a full concurfency review; room additions,
accessory structures, swirnrning 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 t-ecords o1<St.
Lucie Cou my and posted on the job5ita before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or recording our Notice of Commencement.
ign,�ture of Owned LesseefContrattor as Agent for Owner
. STATE OF FLORIDA
COUNTY OF
sworn to(or affirmed) and suhscribed before me of i } Physical Presence of Online Notarization
this lay of �['Pr7rr J r�r,Z0�7 by
Name of person making statement_
Personally Known 4I/OR Produced Identification
Type of Identification Produced+ _
Signature of Notary Public-State of Florida
Commission Nn- (seal) T F.
REVIEWS FRONT ZONING SUPERVISOR PI-ANS VEGFTATiON SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW I REVIEW REVIEW REVIEW REVIEW
DATE i
RECEIVED '
DATE
COMPLETED