HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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c' Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential k
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR: 2- 1ZO J�
PROPOSED IMPROVEMENT LOCATION:
Address: -7 S O & Q `A n A /
Property Tax ID N: 1 321- COQ 6 ' O 11-1- n AD -A Lot No.__�_
Site Plan Name: Block No. �1
Project Name:
DETAILED DESCRIPTION OF WORK:
leap o�� e)Li «j�o ca�� and it�s�allne.+ 51�_�ts cana �,r,cls.r�wnLt�
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 _Windows/Doors Pond
_Electric _Plumbing _Sprinklers _Generator 1e Roof g he) Pitch
Total Sq. Ft of Construction: /$Id Sq. Ft. of First Floor:
Cost of Construction: $ 9i000 Utilities: —Sewer —Septic Building Height: Y
OW NERAESSEE: CONTRACTOR:
Name Velap A lZe Name: Q
Address: /adl S wt• Company: ( pVrr2 O -St QOlt� in
City: YZT6 State FG Address:_"I,", S%-u 14%1 1,t..� R
Zip Code: 3300?O Fax: City:'70c } st. Lj t;t _
State: FL
Phone No. Zip Code: '_\`-,q.�y Fax:
E-Mail: I Phone No `► '7 3 o- g7110
Fill in fee simple Title Holder on next page (if different E-Mail I C 1ZD D �i fNq L-t_Cp�r1A�L• Coih
from the Owner listed above) State or County License_C't, I �JQ G S-A
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
If value of HAVC is$7,5W or more,a RECORDED Notice of Commencement Is required.
DESIGNER ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
i
FEE SIMPLE TITLEHOLDER: _ 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 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-residentlal 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
for an attorney
ttorne before commencingwork or recording your Notice of Commencement.
/Vle 'er 2 Y ! /
S ure o wner/ ssee/Contractor as Agentfor Owner ure of tra c r icense Holder
STATE OF FLOR p — STATE OF FLO A
COUNTY OF�5-iZfe'4 COUNTY OF J /— L)C':—
Sworn to(or affirmed)and subscribed before i Sworn to(or affirmed)and subscribed before me of
DL.Physical Preserjyeor Online Notar ation Physical Presen r Online Notarizatio
this day of J—vL 202� this of �� 202Zbq
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i Personally Known�OR Produced Item c�ti$ Personally Known�_OR Produced Identificati n o n.Y
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ignature of Notary Pubic-State of rida ) a I m N. (Signature of Notary ublic-State of rids j GfD
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FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MACOUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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