HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Q) if �;ZLA lgooZ
Permit Number:
L� F, c l3"' E ° t " Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial clal Residential
2900 Virginia Avenue, Fort Pierce Fl. 34992
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: Run 4r)i 10 4 d L+Xk( Vvv_ *b rpla., k4e V_akv V\ecj,*(
PROPOSED IMPROVEMENT LOCATION:
Address: 05 LnrK Cir
Property Tax ID #: - - - Lot No.
Site Plan Name: +C �" �V�C.kffi�&Block No. 61
ea
Project Name:- '� Q r
►i 1L1 I L� .I�.� L• -- --
New Electrical Meter 1\)f A Second Electrical Meter Il) I 1 (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: Sq, Ft. of First Floor:
Cost of Construction: $ _ utilities: _Sewer —Septic Building Height:
OWN ER/LESSEE: CONTRACTOR:_
Name Name:
` ► C.
Add r s: lG%Ci Company: -
CEty. i staet�; >~Lr Addr s: l C t'_1
Zip Code: Fax: I- C,bCity: . _State
Phone No, alb E- Zip Cade: Fax:-�obR
k Mail: PhoneNo
Fill in fee simple Title Holder on next page cif different E-Mail
from the Owner listed above]
State or County License rC-4 I N3o`i3�
if value 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: -)L Not Applicable
Name: _
Address:
City:
Zip:
Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
Citv:
Zip: Phone:
State:
MORTGAGE COMPANY:
Name;
Address:
City:
Zip: Phone:
Not Applicable 113ONDING COMPANY:
Name; _
Address:
City:
Zip:.
Phone:
Not Applicable
State
Not Applicable
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 5t, 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
with lender or an attorney_ before commencing work or recording our Notice of Commencement.
Signature of Cont ctor - or - Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF
5worn to (or affirmed) and subscribed before me of Physical Presence or —_ online Notarization
this Iq day of , 20 �2_ by
Name of person making statement.
Personally Known V OR Produced Identification
Type of Identification Produced
( gnature of Notary Publ _ State of Florida)
Commi JULIC JANE MCCAr�I)
bt1�5t3t� Florida
Commission d HH 49a 4
osn M CComm. Expires W t, 2024
Bonded through National Notary Assn.
REVIEWS I FRONT _ ! ZONING
GTIONSEA TURTLE MANGROJC
SUPERVISOR PLANS VEETA
REVIEW
_aril REVIEW REVIEW REVIEW _.
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COMPLETED_ ___—_L----_----_ �__�_—