HomeMy WebLinkAboutPERMITAll APPLICABLE INFO MUST 6E COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: `'�)2 -1- 1;�f 1� -a Permit Number:
91
Jae, LL
Building Perm'ft Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Commercial
CBDG Funding
PROPOSED IMPROVEMENT LOCATION:
Address:
Property Tax I #:
Site Plan Name:
Project Name.
Residential
v7L
�-I 4J'=h- toO\ - CK,�2'C-pod-F� Lot No.
DETAILED DESCRIPTION OF WORK:
I k4 02�_Q 0 g - k .0
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
Mechanical � Gas Tank _Gas Piping _Shutters
Electric
,Plumbing
Total Sq. Ft of Construction: -
it 4
Cost of Construction:
OWNER/LESSEE:
,Sprinklers
Generator
Block No.
Windows/doors Pond
Roof
q. Ft, of Fiat Floor:
ti lit i : Serer Septic Building Height.
Name
Address: i4tSL%,,,n
C i tState:c�_.-
Zip Code: � ' � Fax:
Phone No._` � .
Mail:
Fill in fee simple Title Hodder on next page (if different
from the Owner listed above)
E-
CONTRACTOR:
Pitch
a nee: no
Company: C. 1 Address:
it State.
i Code: F�
Phone No I + ��D
E- ail
i
State or County License CO C \ZaL)LA1-k 4�
if value of construction .. is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is 57,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: � Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name-. -
Address:
City:
ZI P - Phone.
of Applicable
MORTGAGE COMPANY: � Not Applicable
Name:
Address:
City: State:
Zip: Phone.
BONDING COMPANY:
Name:
Add r:
City.
Zip: Phone:
Not Applicable
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.
t. Lucie u nt makes no repres ntati ors that is granting a permit willi authorize the permit holder to build the subject structure
rich conflicts ith any applicable Homeowners Association rules, b laws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners Asso iawtion and review your deed for any restrictions which may apply.
consideration of the granting of this requested err it, I do herb agree that I will., in all respects, performer the work
In�
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 concurrent 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 regards 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 Notice of Commencement.,
Sign re of awned Lessee/Contractor as Agent for Owner
STATE OF FLOFII?A
COUNTYOF u i h rl
Sworn t or affirmed and subscribed before me of Physical Presence or Online Notarization
this day of .� ��_. b
Marne of person making statement.
Personally Known OR Produced Identification.
Ty ntif i ca i n Produced 1D
(Signature of Notary Public- State of Florida)
Commission o.
da1*4±1Mi1b9t0M���
REVIEWS
FRONT
ZONING
SUPERVISOR
PANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATA
RECEIVED
DATE -- -� ---
CQMPLETED_—
eV 5/20/21