HomeMy WebLinkAboutBUILDING PERMIT APPLICATION,ii APPLICABLE INFO MUST BE COMPL '_� , ., , __ ,1 D FOR APPLICATION TO BE ACCEPTED
Date: \�\ \a\2.Permit Number:
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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
I PERMIT APPLICATION FOR: e as
Address: 17% "U VUI i
Site Puri Marne:
Project Name:
New Electrical meter SgcQRd Elegtrkal deter (Affidavit required)
RE-CEIVED
DEC 10 2021
St. Lucie COUDIV
Permitti
Lot No.
Block No.
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors _ Pond
�tectric e46
lumbing _,,,,Sprinklers _Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 01) Utilities: _ Sewer _ Septic Building Height:
OWNER ESSEEz
Name ri
Name: ( �z
Address:
Company: vv� Nn
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City: ! * O i re c State: _/
Address:
Zip Code: 2 V2 t Fax:
City:
State:
Phone No.
Zip Code: Z-
.5— Fax:
E-Mail:
Phone No
,
Fill in fee simple Title Holder on next page ( if different
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from the Owner listed above)
State or County License
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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.
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DESIGNE E Not Applicable
MORTGAGE COMPANY: i Not Applicable
Name:
blame;
Address: r
Address:
City: State:
City: State:
Zip: U P on
Zip: Phone,
FEE SIMPLE TITLE HOLDER: _ 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 andcovenantsthat may restrict or prohibit such
structure. Please consult with your Home O:Rmers 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 fP_IIovring building permit applications_ are exempt from undergoing a full =currency review; ropm 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 Cgupty and post
n the jobsite before the first inspection. If you intend to obtain financing, consult
with lehOer or an a rnev before commencing work or recording your Notice of Commencement.
Of Owr erl
as Agent for Owner
STATE OF FLOI%4
COUNTY OF,I I e r
Swor to (or affirmed) and subscribed before me of 'Physical Presence or
tfiis,;; day of G4� 2Q4by
Name of person (Waking statement.
Personally Known OR Produced Identification
of Identification Produc
(Sign re of Notary blic- State of Florida )
REK
Notary tate of Florida
Commission (Seal)
n GG 352016
2023
Online Notarization
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW.
DATE
RECEIVED
DATE