HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFd MUST BE coh,-..TED FOR APPLICATION TO BE ACCEPTEL
Date: 10,11 Permit Number: euvv
Building Permit ApplicationV � �,,,vm
to 10Planning and Development Services iv�P6e�t� /
Building and Code Regulation Division Commercial Residential V
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
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Address: �a0du Pe -I v e #y k
Property Tax ID #: 3 / b c2 - (66 60 Z -060`7 Lot No. if7L Z
Site Plan Name: Block No.
Project Name: 60 Ve(I>°dl(?PDr+
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New Electrical Meter Second Electrical Meter (Affidavit required) iffee7ae 3
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Additional work to be performed under this permit - check all that apply:
Mechanical _ Gas Tank —Gas Piping _ Shutters
Electric _ Plumbing _Sprinklers —Generator
Total Sq. Ft of Construction:
Cost of Construction. $ 02
Windows/Doors
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Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
Pond
Pitch
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Name (z f'Ae d
Name:
Address: Dr ` ' < .
Company:-
City: f--Gr+ Rer-Le State:. iG
Zip Code: 3CI y92- Fax:
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Phone No. 772 -323 E-
Address:
City: State:
Zip Code: Fax:
Phone No
Mail: peal-7-772, IP 6—vh4,' 1. C0/1-
21
Fill in fee simple qitle Holder on next page (if different
from the Owner listed above)
E-Mail
State or County License
If value of construction is 2500 or more, a RECORDED Notice of Commencement is requires.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
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MORTGAGE COMPANY: Not Applicable
DESIGNER/ENGINEER:• ;. 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-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 th,e first inspection. If you intend to obtain financing, consult
with lender or an attorneybefore commencingwork or recordingour Notice of Commencement.
Rev
14
I
Signature of•Corit�ac#or - or -
er Builder as applicable
STATE OF FLORIDA
COUNTY OF 0�
.
Sworn to (or affirme and subscribed before me of Physical Presence or Online Notarization
this