HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: - Permit Number:
9`Lr, L u LLL
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' 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: C-C,
93-45ED 1MP`R0VEMENT; L*OCATIQNts}
Address: V�i Pr(' l- W.0
Property Tax ID #: - i��J ^ I�fJ[� 3 Lot No.—k�`—
Site Plan Name: Block No.,L—
Project Name:('
URO-A-II+ED-DESCRIPTION-OF WORK:11�. ti. s,} 's" `1�"t'F
New Electrical Meter
Second Electrical Meter.
(Affidavit required)
MIDTiSTRUCTION INFORMATION'''+, �'rdd
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Additional work to be performed under this permit -check all that apply:
_Mechanical ` Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
ElectricPlumbing �\ _Sprinklers
Total Sq. Ft of Construction: a �V
Cost of Construction: $ irJ GS
_ Generator ✓Roof 5Z 1 -" Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
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Zip Code: �Jt-{A S1 Fax:
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Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License
if value of construction is 2500 or more, a RECORDED Notice of Commencemenz is requirea.
if value of HAVC is $7,500 or more, a RECORDED Notice of Commencement Is required.
SUPPLEMENTACQ
DESIGNER/ENGINEER.
ON LIEN LAW INFORMATION:
Name: _ Not Applicable
Address:
City:
Zip: Phone State:
r« aimrCt 11TLE HOLDER:
Name: Not Applicable
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name.
Address
City:
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 the first inspection. If you intend to obtain financing, consult
with lender or an attorney before Commencing work or recording your Notice of CommencemPr,t_
Signature bl-C or- or- Owner Builder as applicable
STATE OF COUNTYOFORIDAS ' C
Sworn to {or affir and subscribed before me of Physical Presence or online Notarization
this,a3 day of ¢tlj 20c3aby
Name of person making statement.
Personally Known J OR Produced Identification
Type of IdentificcAtioa-Prvd=ed__� _
otary Public- State of
Commission No. (Seal)
REVIEWS
RECEIVED
DATE
COMPLETED
FRONT I ZONING
COUNTER I REVIEW
Thiago Batas
Notary Public
State of Florida
L CommN HH111375
• �y�a Expires 3/30/2025
SUPERVISOR I PLANS I VEGETATION SEE AV RTIE I 14AN13
OVE
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