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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ooa5� — Permit Number: jwo l ' �0 t'' .,3 .:•-„ a:Ms-,:,. �y= 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 PERMIT APPLICATION FOR: Address: A ® ©cF 4<0 Property Tax ID #: 13�ja 0 ��' ��15� • ((1�i00 Lot No. Site Plan Name: 1 (( n Block No. Project Name: C>Ue_e':M ,, it -►-*� lJc�'� �IC�-%�i G New Electrical Meter Second Electrical Meter (Affidavit, required) Additional work to be performed under this permit — check all that apply: Mechanical Gas Tank —Gas Piping _ Shutters XElectric _ Plumbing _ Sprinklers _ Generator Total Sq. Ft of Construction: g b(� 00 Cost of Construction: $ Windows/Doors _ Pond Roof Pitch Sq. Ft. of First Floor: Utilities: _Sewer _Septic Building Height: Name J.. IZ, 0- - - Address:�-� City:State Zip Code: ,3X. Phone No. 0® E-Mail: w�c►�i.�-�tk�� �i o"`c`` . C'a Fill in fee simple Title Holder on next page { if different from the Owner listed above) Name: Company: Address: City: State: Zip Code: Fax: -Phone No E-Mail - State or County License If value of construction is 2500 or more, a RECORDLU notice or l,ommencelnellL 1� 1=yu If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. - J MORTGAGE COMPANY: _ Not Applicable DESIGNER/ENGINEER: — Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLEHOLDER: _ Not Applicable BONDING COMPANY: 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 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. Signature of GVerl Lessee/Contractor as Agent for wrier STATE OF FLORIDA COUNTY OF Sworn to (or affirmed) and subscribed before me of _ Physical Presence or Online Notarization this day of 2CQU_ by Name of per+ n making statement. Personally Known OR Produced Identification Typ of Identification Produced (!*Are re of Notary -Pub lic- S to of Florida ) Commission No. (Seal)" :•• �. &-YP •• LASRAMNAINGRAM-RAMMING MY COMMISSION # GG 275060 EXPIRES: December 20, 2022 er uF v'•` Bonded 7hru Notary Public Underwriters imam - REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW- REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 2 21