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HomeMy WebLinkAboutBuilding Permit Applicationv. J V All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: &� Permit Number:"MMIVED JU. IL All O Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: Address Property Tax ID #:k�°��5�� •-ID�38—�©� Site Plan Name: Project Name: New Electrical Meter Second Electrical Meter AUG 0 0 2021 bt:I U§Ijft"ty Residential --ill, (Affidavit required) Additional work to be performed under this permit - check all that apply: _Mechanical _ Gas Tank —Gas Piping _ Shutters Electric X Plumbing Sprinklers Generator Lot No. \� Block No. mac' Windows/Doors _ Pond Total Sq. Ft of Construction: 1z63 Sq. Ft. of First Floor: Cost of Construction: $ N21:k oaa'cp�V Roof Pitch Utilities: _Sewer _Septic Building Height: e'�5s,a.f: .Y` s ki'tF $ice * ➢tv�e rs ?k'j a' 's - - .`„'�', f ��.`...R�i;�.iYk v� Name ')IAS Vk0-VS y !•Narr�e: 'AtExkJ"MJ1, 'B-. 3 Address::3\--+\ SW3 Company:' State�3��t`�Address: �� %Ail 'reS O— ��® i Zip Code: 37kR53 Fax: City` `��� Stated Phone No. Zip Code: olj3 Fax: Phone No E-Mail: Fill in fee simple Title Holder on next page ( if different E-Mail c-AOc-b(.1. "\: S -q'Y0" �• 1 State or County License C-P50— from the Owner listed above) If value of construction is 2500 or more, a RhLUKutu Notice of commencement is requireu. If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. X * Fill ' Ji 'E,V I f4R}"' l-;l111" DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: Not Applicable Name: Address:-161cl Address: City: - Stater PhonEf-bA. _\SC(v City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable Name: BONDING COMPANY: Not Applicable 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 ariattcKney before commencing work or recording your Notice of Commencement. Signature of as STATE OF FLORIDA A COUNTY OF Swoq�&o r affir d) and subs ribed before me of Physical Presence or Online Notarization thisy of 20&1 by 1 1 n Name of peHon making statement. Personally Known OR Pro uc d Identification Tye of Identification Produced (Signatureof Notary Public- Startle of Florida`) Commission No. (Seal) REVIEWS I FRONT I ZONING COUNTER REVIEW DATE RECEIVED DATE COMPLETED Eizabeth Novak Notary Public State of Florida My Cornmisslon Expires 061051M Commission No. GG 225309 SUPERVISOR REVIEW I I PLANS VEGETATIREVIEW S EV EWLE I MANGROVE