Loading...
HomeMy WebLinkAboutBuilding Permit Application Ail APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I ; - .ao - d `- . Date: :; 1�1a01 Permit Number: s -L It Ilg QD - Building Permit A - ication Y I !Planning and Development Services 'Building and Code Regulation Division Commercial Residential 12300 Virginia Avenue,Fort Pierce;FL 34982 'Phone: (772)462-1553 Fax- (7:712)462-1578 CBDG Funding I 'PERMIT APPLICATION FOR: oZ� Site Plan Name: 6 I �{ Block No. Project Name: aA Al 1 Jn,--- I s3.;�pa 4 ���.„i: �l I +-s.r aa-�«-•.-�. ��r'� �. �'"ja :ip r'° 1� � t m� _r. .�y��,�E ,� �; �, i ;New Electrical Meter Second Electrical Meter (Affidavit required) i I Additional work to be performed under this permit—check all that apply:: _Mechanical _Gas Tank —Gas Piping _Shutters —,Windows/Doors _Pond I � t,Erectric Plumbing _Sprinklers _Generator _Roof Pitch. I Total Sq. Ft of Construction: I Sq. Ft.of First Floor: Cost of Construction: $ Utilities: —Sewer —Septic Building Height: y�ls .. 3 '�'�Fj{"�-:��:ar,�� (`-+-'jr!!�•N'�n1I.1 r: e I '. t ��.� a� � z (�ja�o-�ic,.•*'G,:r� $!' � ON M� ,y} faF:. +Y ,d��i ., ?�s �•�.?-+EF' rA� �` 1,�_-�^" Name f-1, 7e, Name:, 'mac r/1 vC k Address- 1��0 'b� ' Company: ,gOl',9 4 City: /W V, State: _ Address: ��'6 :5� P4✓r Y Zip Code: Fax: City: -11-- 4—Vz- State: ClJ Phone No. 7(DJ J V E- Zip Cod"e: L, I S>e�_Fax: _?>— Y 7_0 ?S Mail: Phone No Fill in fee simple Title Holder ion next page (if different E-Mail h from the OWner listed above,) State or County License If value of construction is 250Q 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. II II 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-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 commepqng work or recording our Notice of Commencement. SigAQ14r,PJof Contractor-or-Owner Builder as applicable STATE OF FLORIDA COUNTY OF (�'�'LLl QS�-__ Sworn Jo&r affirmed)aan�subscribed before me of �al Presence or Online Notarization this day of r'""��/ 20— Name of person making statement. Personally Known OR Produced Identifi ation Type of Identification Produced (Signature of o N ELLEJ lP PVB iCommission ag ;State of FI ida-Notar� �,a GG 270 -� - Commission Exp 9, oec My ' EOFe ©elober 29, � REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev