HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLI ABLE INFO M UST 13E COMPLETED FOR APPLI CATI0N TO BE ACCEPTED
Date: Permit Number-
UT
IL
BuildingPermit Ir a i n
Plan aln y aad Development Services
Building and Fade Regulation Division Commercial Residential
300 Virginio A venue{ Fort Pierce FL 349S2
Phone- (77 ) 46 -1553 Fax: (77 ) 462-1578 CBDGFunding
PERMIT APPLICATION FOR :
PROPOSED IMPROVEMENT LOCATION :
E
Address. 94oO
Property Tax ID z2 3� o o oo Lot No .
Site Flare Name- Block No.
Project Name-
............. ............. ..... .. ............
T ILED DESCR.IPTION OF WORK :
: 1..
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M soatin
Lt ,f roLiar 6 __
1&4eCh
3/ 1
As 4r h
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New Electrical deter Second Electrical Deter _ (Affidavit requ i red)
CONSTRYCTION INFORMATION .
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Additional work to be performed under this permit — check all that apply:
Mechanical - Gas Tank Gas Piping Shatters Windaw0ocrs Pond
Electric Plumbing Sprinklers i Generator Roof Pitch
Total Sq. Ft of Construction : Sq, Ft. of First Floor;
ou
Cost of Construction- _4,S-53 � Utilities: � Sewer Septic Building Hight: _
,1 W N E LFFrYEl E .M1 • M1xr h}i .:�
� CONTRACTOR :
Name ' - - 4t zll:> Nn M'&
Address: biri Vim' Company: ph
at.. E49-0pier4emeel- tat : L Address: SW * 12400f
Zip � �Code: Fax: city: State: FL. {
Phone No. T _WQ 1 rw 4MI I Lo E- Zip Code: 3qdq Fax:
ail : i # Phone No `
--
Fill in fee simple Title Holder on next page if different E-flail 7?p,.drhdn R.4n4x,, iwL if 43tnAi WY
from the Owner listed above) State or County License
If value Of WnAtuction is 2500 or more, a RECORDED Notice of Commencement a nt is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
:SUPPLEMENTAL [ T U TIO LIE 1 LAW INE I IATION :
_
5 E I IEt E l If EEF : Not phicableMORTGAGE COMPANY: CApplicable
[Name : Marne - *'
Add re s. Address , f ' -
City: 'state, it : State ;
iP: Phone Zip: Phone: -- --
FEE SIMPLE TITLE HOLDER: of Ap pkable BONDING COMP NY. Not Applicable
Name : off a rre
Address: ' Address :
City: city:
Zip: Phone: - - Zip' - - -- - - Phone- -- -
OWN E R CO NTI A TO R A FFI DVITt App I i cation is he reby rn ad e to o bta i n a p erm it to d o th e wo r k a n d 1 nsta I I a tion as i nd i cated+
certify that no work or installation has commenced prior to the issuance of a permit.
t. Lucie County males no representation that is granting a permit will authorize the permit holder to build the subject structure
hick conflicts with are applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit .such
structu re. Please consu-, t with your H o m eow ners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in al I respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendrnents.
The following building permit applications are exempt frarn undergei ng a full concurrency review: room additions,
accessory structures, s irnrning pools, fences, wafts+ signs, screen rooms and accessory uses to another non-r-esident[af use
WA RN IN G TO OW N EFL: Your failure to Record a Notice of Commencement rn ay rl+esuIt i n paying twice for
i r prcvements to your property. A Motive of Commencement must be recorded in the public records of St.
Lucie Count d posted on the jobsite before the first inspection . If you Intend to obtain finariciing$ consult
- with lender Wan are attorney before c encin work or recordi n our Notice of Commencement.
- L
ignat f Contractor - or - Owner Builder as applicable
STATE 0 F F LO R I D A.
COUNTY OF �
Sworn to (or affirmed) and subscribed before me of Physical presence or Online Notarization
this j ?) day of 0 by
i LV.1 A Ea.r 'I d r) r
Name of peas n making statement.
Persons IIy Known n OR Produced Identification
Type of Identification Produced
( ignature of tart' Public- State of Florida A, TEA
Com mi.s ion No. ;� � �-' � � (seal) Notary Public
State of Florida
Comm# HH149097
t is Expires 7/5/2025
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW R EVI EW REVIEW
DATE
RECEIVED �
DATE '
COMPLETED