HomeMy WebLinkAboutWharton Permit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit [Number:
9-17, 1 U1, Of [I E —z—, I E,0
cc B Wr 'VIC
Building Permit Application
Planning and Development Services v�
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:
PROPOSED IMPROVEMENT LOCATION:
Address: 6e) c) a L"aj-4 -b v6
Property Tax ID #: 1301 . (ODq • Do DCO -3 Lot No. 1 4 Z
Site Plan Name- Block No.
Project Name: _D)h&W)o O-V1f4
a, ITc-ded, na&'b&s,(-. In ce6ic. 14,),sfall 11 -10 Cock.
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New Electrical Meter Second Electrical Meter
ZTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_,Mechanical — Gas Tank —Gas Piping Shutters — Windowz/-Doors Pond
— Electric — Plumbing — Sprinklers — Generator ��Oof, . Pitch
Total Sq. Ft of Construction-, Sq. Ft. of First Floor:_
Cost of Construction: $ IS-4:15 t� Utilities, —Sewer _Septic
2 1�4 1.
Building Height:
OWNPAESEE-,
CONTRACTOR:
Name -HULD 11
Name: CQWW-V01/-N CoOlDc—',—
Address:eE= t yukarla avct
company: Ra-�.. CDo-6t"
city-, Eb± Pistat&'DI
Address: 175�b 5'F— G
Zip Code: Fax:
C!ty. i c,V State:
Phone No.
Zip Cade: -,5&57— Fax:
Phone No TfZ 0,21 tO 2- b,8
E-Mail:
Fill in fee simple Title Holder on next page ( if different
E-Mail 0 am. a
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.
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Name:
Address:
City: State:
FA on ..
ppczl�r -
Address:
City:
Zip: -
MORTGAGE • Not r r . s-
A-ii
City: State:
Zip: Phone:
BONDINGCOMPANY:
Name:
Address:
City:
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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 attornev before commencine work or recordine your Notice of Commencement.
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1
gnature of ner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE FLORIDA �
STATE OF FLORIDA I
FLORIDA
COUNTY CIF
COUNTY f3 c_
Sworn to (or affirmed) and subscr: d before
me of
Swo to (or affirmed) and subscribed before me
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al Pre n or mine otariz
this day of 20:11L by � "o
at Pr c or Online Notariza
thi day o 2Q22d byMA�
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Dame ofperson making statement.
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ame of person making stat nt.NPersonally
Known OR Produced Identifi tiQrg �Personally
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$ 3 Q
entification
Produced
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(Signature of No I c- tate of Florida
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(Signature of No blic- State of Florida }
Commission No, '� T % (Seat)
Commission No. CPS410 (Seal)
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DATE
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COMPLETED
Rev. 20