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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICAB E INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ? 0?00?'.Z Permit Number: �T,'n L-L(:�>JL . 9 LL L` Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial ✓/ Residential 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding PERMIT APPLICATION FOR: 2�'Is C_. PROPOSED IMPROVEMENT LOCATION: Address: oc �'y� iC d&Xe Cc-kT L c ez..p Property Tax ID #: i/--? - 000 / - 600 -,5- Site Plan Name: Project Name: Lot No. Block No. DETAILED DESCRIPTION OF WORK: �1,� c� iY ✓,_.Q,.�2 S�-a. K o9/'erg .� l.e c ••I•-�, c� .I.� r v c.c. � v G'oa-r.nr� w�' �� 9�-�e -�-i 24=.n /2 4✓ �e ��'✓�/ S'i 9� Tom, c New Electrical Meter 1/ Second Electrical Meter CONSTRUCTION INFORMATION: (Affidavit required) 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: J/ Cost of Construction: $ Sq. Ft. of First Floor: _ Utilities: —Sewer —Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name D _.Qo Name: Address: Gl_o, - Company: J.)tc_),,1!�_/ PC 1�✓. G; /n c. I tt� City: PT f4 Lce- C.e State: �L Zip Code: �y01S2 Fax: Phone No. E- �r Address: -o / 4-,?• 1, City: f 7• �..Q✓e_, Zip Code: yCi y$� Phone No State: 1 L Fax: -art Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail f,y S,f'i'e-&. S%tcbb.f . S� e J1.ec4r. c C State or County License ,4�G /.3a0 -7XsIV 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: Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: Not Applicable 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 is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Home Owners 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 with lender or an attorney before commencing work or recording our Notice of Commencement. Si nature of wner/ Les ee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF E� Sworgto (or affir ed) and subscribed before me of Physical Presence or Online Notarization this» ' day of, `' 20 by Name of person making statement. Personally Known OR Produced Identification Type of Identification Produced `! J� (Signature of Notary Public- State of Florida ) Commission No. C (— rJ �,t' �Scl(Seal) ip��°� Notary Public state of Florida Ginger P Hester v My Commission GG 330259 Y y'twA Expires M2512023 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE I RECEIVED DATE COMPLETED Rev -( Rorf- G r C, Lvs-' Gay Iry ... re Scheel QL-- &-c) ' c9L, THW Cu o r,ala t---o rS q Lj o n o 6 e, ©-,t,-c S L-q �,- g at-e_ P,,,1 P a Pv"e to Cn fh S"3 A �lvoc� �S 5