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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETE© FOR APPLICATION TO BE ACCEPTED Date: 21— / J- ,=,2,)_ Permit Number: 0 J Building Permit Application Planning and DewtopmentServices Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax:1772) 462-1578 C8DG Funding Address: Property Tax ID #: J o Q Q ` Q �� �f7� Lot No. Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION OF WORK: -Ke-hl�a�e &0 ga&o17 elccfrl6 t�dfer.-heaJ-er r 1-1`te 4cy- 4 ke" New Electrical Meter Second Electrical Meter (Affidavit required) CONSTRUCTION INFORMATION: Additional work to be performed under this permit— check all that apply: Mechanical Electric T Gas Tank /Plumbing Total Sq. Ft of Construction: Cost of Construction: $ 06, —Gas Piping —Sprinklers Shutters Windows/Doors Pond — Generator — Roof Pitch Sq. Ft. of First Floor: utilities: —Sewer ,Septic Building Height OWNERAESSEE: CONTRACTOR: Name V AN7 Name: JUa r a L) 1 6 Address: " I S C! l ® Company: PDrt R �f�L!Ina City: State: ` Address: 0 ei- [R e r Zip Code: � f City: � t iCIP State: t t� /Fax: Phone No. 77 ,&9,-1"6 16,5 E- _iQl Zip Code: 34i5l Fax: Mail: _ Phone No 77e,3 1648-6 5,� q Fill in fee simple Title Holder on next page {if d'dFerent E-MailL1 G I,{ M in COEK from the Owner fisted above) State or County License C FC, 083 29 d 5 If value of em►Stmction is ZW or more, a RECORDED Notice of Commerucemem is r"u'-red. If value of HAVC Is $7,510 or more, a RECORDED Notice of Commencement Is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: i DESIGNER/ENGINEER: Not Appl Name: Address: City: State: Zip: _ Phone FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: Zip: Phone: MORTGAGE COMPANY: Name: Address: City: Zip: Phone: BONDING COMPANY: Name: Address: City_ Zip: Phone: _ Not Applicable State: —Not Applicable 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. 5t. Lucie County makes no representation that is IVntin 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, h 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 attomey before commencing work or recording our Notice of Commencement. SignatT_ f 4 er/ Les e/Contractor as Agent for Owner STATE OF FLORIDA j 5h COUNTY OF Z Swo a for affirmed) and subscribed before me of Physical Presence or Online Notarization this I `jday of 6Pn6 , 20�-1 by Name of p rson making statement. / Personally Known OR Produced Identification Type of Identification Produced (Signature of Notary Pu is -State of Florida) CAa�GG $5$"m m. Commission NoJ �_r7S (Seal) Y« � • Bff"E*uAuFd25,20 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 5720721