HomeMy WebLinkAboutBuilding pemrit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
S.
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial
CBDG Funding
PERMIT APPLICATION FOR: M�c«4Ni C4 L
PROPOSED IMPROVEMENT LOCATION:
�
Address: � `25C' E5Cllri'.s C—!
Property Tax ID #:j�
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Residential I%
A1(»�,�i r -A WYIS . �.
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
Additional work to be performed under this permit- check all that apply:
WOechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers Generator Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of Construction: $ Wuo-oij Ut'lities: —Sewer _Septic
Lot No.
Block No.
N
_ Pond
Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name E `IS -cm `Fn (Y-e
Name: l n -QbO n V—c
Address. TZEC Y-f�SE.N-IF., CV=C&& - .Df-- -
Company: Eli ..��t, Y1C� COCA Mr
Cit t- 'St �.(.�.C'�t t, State:
Y� �.,
Zip Code: 13cria-0 Fax:
Phone No. 2 ? ` KD' � E-
G i'- tL�t � e) QCJ
Address: � (.G' l � 51+'�% � �
City:Tb�t st u- 1 '{� State: 'EL
Zip Code`' q Fax:
Phone No
E-Mail grin it@C lj i'� e�(�.t✓�j'I C,GiI c��
State or County License
Mail r hQ � 1- -
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
voMC W L 13LI YL.LIVII IJ 47VV Vr F11UFC, a nt LuKuru rvoiice or 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: )r Not Applicable
MORTGAGE COMPANY: )(_Not Applicable
Name:
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
f)WNF:R/rnNTQArTnD ACEAM 'r
,.,,,, , , „NP,,cdL1en is nereoy 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 co nsu t 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: 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 attornPv hPfni-P rnmmcnrinr ,. _ L ,r r ,r.Jt..— ., ft —mac__ _r
uli IV, VVUI rvULlUt u1 wmmencement.
Signature of Cont ctor - or - Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF S- LO C rE
Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization
this __2�day of_ /-'¢i3 ,20ZZby
20'}N P4,v KR q- L
Name of person making statement.
Personally Known _X OR Produced Identification
Type of Identification Produced
(Signatu a of Notary Public- State of Florida)
Commission No. / 3 (Seal).
6! j
;� r'uB-.. KONNI LENAE DEWITT
-, Notary Public - State of Florida
Commission # HH 16513a
My Comm. Expires Dec 10, 2025
Bonded through National Notary Assr.
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