HomeMy WebLinkAboutBuilding Permit Application All APPLI INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Per Number:
Date: 202Z� ,
•Lucie County
Per
Building Permit Application
Planning.and Development Services
Building and Code Regulation Division Commercial Residential x
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772) 462-1578 CBDG Funding
-PERMIT APPLICATION FOR:
Site Plan Name: Block No.
Project Name: /-\G Ci AkQ GE d V - -InN
r
0 -Tom
Ir"x..1?•'? ,ia� NRIPIM ,�.��s,:".fi.' ...-a... sr � '_' ,..: ..�s:.� '8' e.. v .ti•— ii.
(A �A oKw aT
New Electrical Meter Second Electrical Meter (Affidavit required)
Additional work to be performed under this permit-check all that apply:
Kmechanical _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: $ tl Utilities: —Sewer ._Septic Building Height:
NE
Nit:2 �
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Name: l�A-T,?-T 7_
Address: 'uL.l_d�CT�. �L�G� Company: OR%'? PW, ntlR 1LON10- AIR t05AJJ?J- (�
City: PO i S�' Luc- tE State:F' 1 Address: GO 13 PAPA-64 b L
Zip Code: 34!9sa Fax: City: 'o(Z-T ^�I{-��C State: L
Phone No. 1 �Oa_ �5 � E- Zip Code: k�4 ot Fax:
Mail: Phone No 7�a ;kLi a G a a o
Fill in fee simple Title Holder on next page (if different E-Mail o 6-h("tr—0.4 (A
from the Owner listed above) State or County LicenseQA ol5
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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Applicable Applicable
alit
DESIGNER/ENGINEER: _Not App MORTGAGE COMPANY:. Not pp,_
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone 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'conflicts with an 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•ar,,e exempt from undergoing a full concurrency review: room additions,
._,
accessory structures,swimming pools,fence's,walls,sighs,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
wit lender or an attorne''before commericin 'work or recdrdin our Notice of Commencement'.
Signature o ntractor-or- er Builder as applicable
STATE OF FLORIDA L
COUNTY OF
Sworn to(or affirmed)and subscribed before me of V Physical Presence or Online Notarization
this_V day of_ 20
Name of person making statement.
Personally Known O.R Produced Identification
Type of Identificatio ,Produced
(Signatu cata
�SaYPue ELLEN VAUGHN
Commis c ` ,State-of'Florida- t y Public .
tifiy commission Expires ,
'
• �i/I oc F�\\ OCt_ObBr 291 2022 -
REVIEWS FRONT ZONING:. SUPERVISOR PLANS VEGETATION. SEAJURTLE MANGROVE
COUNTER: REVIEW REVIEW REVIEW' REVIEW REVIEW ^ REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 10112121