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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:Permit Number: o12 1 I 1 c'i Ilo L�C����S' �'. RECEIVED LF Building Permit Application NO Planning and Development Services St. Lucie C;ou tyC/ permitting Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: 5 '� 9' - - __ Address:` C L1�r i TG ` t� Property Tax ID'#: `,�U� �® 05 7 y' Lot No. Site Plan Name: Block No. Project Name: New Electrical Meter Second Electrical Meter (Affidavit required) 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 _ Roof Pitch Total Sq. Ft of Constr/�%eGi +y Sq. Ft. of First Floor: Cost of Constructioni'�" _ — ' � ® Utilities: Sewer Septic Building Height: Name e—, Otbe ',It 4 A a S Address: 4 ®©'7q7? a,2 City: 3���' 2- State: Zip Code:1,�LGg�� Fax: Phone No. 49) —0 _3 7 E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name: Company:_ L�2ieY4-0_4Y Address: f a % r to '- City: )C�A- State: Zip Code: Cg'lei Sf �- Fax: y Phone No / 1%a 9 t1*_S P� E-Mail Orrxe F&M- A &L State or County Licensed r 113 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. MORTGAGE COMPANY: _ Not Applicable rDESIGNER/ENCGINEER: _ 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 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-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. Sign` ure of Owner/ Lessee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF cS�LU C" <sical Swornt (or affirmed) nclsu scribed before me of Presence or Online Notarization this �y of 20AI by Name of person making statement. Personally Known OR Produced entification Type of Identification Produced (Signature of Notary Public t to of Florida ) Commission No. (Seal) HEATHER BURFORD 'State of Florida -Notary Public _+ += commission # GG 183217 OFF���O` My commission Expires Mill February 06, REVIEWS FRONT COUNTER ZONING REVIEW. SUPERVISOR REVIEW PLANS REVIEW VEGETATION REVIEW SEATURTLE REVIEW MANGROVE REVIEW DATE RECEIVED DATE COMPLETED Rev 2 2