HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED'
Date: �'� ��, Permit Number:
Uo [LUC.01E ` A
O
P o 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: ..1001-e ,60 ri)
PROPOSED IMPROVEMENT LOCATION:
Address: -1 a co 3 a . Pi n-e Con- L.M a 4 , (;i e'C-e_ , . FL- 3`I 9y5
Property.Tax ID #: 01 OOQ Q D OD f y Lot No. 4
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK: ,
i nsfa-!I pole barn v9 X 30
New Electrical Meter
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
Total q'S,�vdo Cori st t cfion Zi yO vk. Sq
Cost of Construction: $ Utilities:
Generator _ Roof Pitch
Ft. of First Floor:
_ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name r% inn e,Sf-er
Name:
Address: / 04P 3 a i' n e c pti e. LA4
Company:
City: P -, % eXr-4 State: (CL
Address:
Zip Code: Ai'f K5 Fax:
City: State:
Phone No. %7o?• 4§6 a0 b E-
Zip Code: Fax:
Mail:'{ 1 G e-rS 1 `7 CC) V6 _hQP C Dn'1
Phone No
E.-Mail
Fill in fee simple Title Holder on next page (if different
from the: Owner listed above)
State or County License
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
MORTGAGE COMPANY: Not Applicable -
Name: MichcteJ. cdA.)a d
Dr isco I.
_
Name: -
Address: P6 o X 357 57-
Address:
City: Gt11.n-P5Yi W a
State:
City: State:
Zip: 3IRQ0c(i Phone 35Q - 331 - IS 15
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.
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 anyy 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 St. Lucie County Amendments.
The following building permit applications are exempt -from undergoing a full concurrency.review: roon 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. Ifyyou .intend! to.obtain financing, consult
.with lanitpr nr.nn attnrnpv hpfnrp rnmmpnrino wnrk nr rernrding vnur Notice of Commencement.
Signature of.Contracto -. or -Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF -LLB.P
Sworn to (or affirmed) and subscribed before me of lzphysical Presence or Online Notarization
Phis ''day of'.11�,, 2C ' 20� by-
Name of person making statement.
Personally Known OR Produced Identification
Type of I entification Produced
(Sign ture of ary Public- State. F ida)
Commission No: d�.� (Seal) ;gip<�"Y'6 :• KASEYMGOFF
. . ^ Notary Public . State of Florida
Commission #HH 072730
r�< .
A„ AY Comm. Expires Jan 24, 2025
Bonded through National Notary Assn.
REVIEWS FRONT AZONING SUPERVISOR PLANS. VEGETATION SEATURTLE MANGROVE
COUNTER . REVIEW REVIEW REVIEW', -'REVIEW REVIEW REVIEW
DATE .. .. . .
RECEIVED
DATE
COMPLETED
Kev zu/iz/zi.