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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: d. /5 -o7a Permit Number: S6,�n Lurcm Cab Building Permit Application Planning and Development Services / Building and Code Regulation Division Commercial Residential Vi 2300 Virginia Avenue, Fort Pierce FL 34952 Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding PERMIT APPLICATION FOR: F/u m bl'a PROPOSED IMPROVEMENT LOCATION: Address: 7 LAe ! ,5 Gt (�ll i �� (� Q r� S f ' L a 6 PropertyTaxlD#: Site Plan Name- Project Name: DETAILED DESCRIPTION OF WORK: LJ 000116 r L.1/ K e WaTer t7en 7e r New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: Additional work to be performed under this permit— check all that apply: _Mechanical _ Gas Tank —Gas Piping _ Shutters L 3yg5z (Affidavit required) — Electric /Plumbing _Sprinklers Generator Total Sq. Ft of Construction: Cost of Construction: $ 0,00- _ OWNER/LESSEE: Name W flfa'M .SM; Lot No, Block No. _ Windows/Doors Pond Roof Pitch Sq. Ft. of First Floor: Utilities: __._ Sewer _ Septic Address: q ke `-5 lac % t''a i l /a 6 City: _ESL- State: r-L Zip Code:.l � 4 6'?_ Fax: Phone No. 77a 777 L15o6 E- ntail: Fill in fee simple Title Holder on next page (if different from the Owner listed alcove) CONTRACTOR: Building Height: Name: Company: ort S Luc( e. u Address: cQ t r; ci r City: Di S] L.(.I.CIe State: 64 Zip Cade: 3415.7- Fax: Phone No 77,26g-�o5a ` E-Mail Cf f (. aie UM In Nal C'oK State car County License % K C o$ D d 5 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 Name: MORTGAGE COMPANY: Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: ^ Not Applicable Name: Address: City: BONDING COMPANY: Not Applicable Name: Address: City: Zip: Phone: Zip: Phone: f1fAl1►It� / NAI►ITs wr`T�n w rr■..• �■�_ U V J V"v ..v+• a HAL a Vn tarn u v e 1: 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 any. 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: 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 attorney before commencing work or recording our Notice of Commencement. Signat r f erf Les a/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF 51. L to e, Sworn to, (or affirmed] and subscribed before me of V Physical Presence or Online Notarization this /5 ; r`,day of Pi 20 216L by Name of p frson making statement. Personally Known V OR Produced Identification Type of Identification Produced (Signature of Notary Pyolcc- State of Florida) Commission No. 603Z 0 4M (Seal) REVIEWS I FRONT ZONING COUNTER REVIEW IlFT1i0 DATE COMPLETED Com IGG381638 BGII W Tlili Aaron Wally SUPERVISREVIEWOR REVIEW 1 PLANS I VREV EW©N I S REVIEWLE I MANGROVE