HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: CCj5r-L PAr2 y @ 7. z� �
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
,K
Address: 2-7 1JL suLa Aftn►V Roui L�ci� �nyy
Property Tax ID#: 34i r s-7t) c -J OCc ?-� Lot No. zs
Site Plan Name: i c-A�- i&I-C -2,V1 Lc_ Block No, 2-
Project Name: L. "A-- F-,,ucL-'
DETAILED DESCRIPTION OF WORK:
Ale r 'p4Xoc- rJ,+ JL i L, - iA1 X rJ1- c L J Q i ' L - F _
2 LAt -T-
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
Mechanical
Electric
Gas Tank
Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $
OWNER/LESSEE:
-S!, 7-53wr-xrakL1
_ Gas Piping
— Sprinklers
Shutters _ Windows/Doors Pond
- Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: — Sewer _ Septic
Address: 2`7L' A1L .SoLtr]A><cv4
City: 11K7" S-, Lvri� State: 1=L
Zip Code: Fax: —
Phone No. 77 z s -7-7 4,o-.'9 E_
Mail: i4& JenA1iL (2!v, vs7rc Ca t
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
Building Height:
Name: �:�lcrtiLfL 1�rrIcLY
Company: A G.-Lo
Address: 7-s-/ xi cv
City: State: i L
Zip Code: 3Y�kV Fax:"772
Phone No 772- cTlZ &223
E-Mail iAlF0 61 Lr�t�r; Frr.cc'� crG
State or County License C CC i2i-27s71
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 MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State:
City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: 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 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-rPcidanriai iico
WARNING TO OWNER:
improvements to yl
Lucie County and p
with lender C anY
Sur fail re to Record a Notice of Commencement may result in paying twice for
r property. A Notice of Commencement must be recorded in the public records of St.
ed' n e j site before the first inspection. If you intend to obtain financing, consult
r` efo co mencin work or recording our Notice of Commencement.
Signature of Cont for - or - Owner Build
STATE OF FL "RIDA
COUNTY OF 5�- L t,e
as applicable
Sworn to (or affirmed) and subscribed before me of Ph�]{sical Presence or Online Notarization
this '1 7 day of f eY7sius �1 20 2-1—byufJ+�►[�rA"Z:- 0,41LL-'-'"If
Name of person making statement.
Personally Known .L OR Produced Identification
Typeentification Prodm—,Pd
(Sign"M—ure Of Notary Public- State of F
CommissiA No.0 ° 929,5 'r (Sea#
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
YON
Notary Public State of Florida
Crystal E Naylon
My Commission GG 829549
Expires 1 IIDG12023
SUPERVISOR � PLANS
REVIEW REVIE"
'
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW