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HomeMy WebLinkAboutBUILDING PERMIT APP - FREELAND All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 3 Permit Number: D 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: ®� + b �7 PROPOSED IMPROVEMENT LOCATION:,,rr�� Address: q 50 S �Y1 ... � K 1 d Q_. T)r Property Tax ID#:_ J q 4 L4 - 0001 -OC` -- _ Lot No. Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION OF WORK: New Electrical Meter Second Electrical Meter (Affidavit required) CONSTRUCTION INFORMATION: Additional work to be performed under this permit-check all that apply: Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Pond V/Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction: $ q Q J 5 (-P,. O0 Utilities: —Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Cl�S 4- 3 Cc. i i r(e-,e o_j J Name: 730 CSC. Address: q®U l I ;0h ` Company: &, rn -e t t r r . Mc�_r+r-s., City: { <-Q� State:SC Address: d.O© N Q C b Zip Code: a C1 k)I Fax: City:44 - Pl- 4 ('C-e_ State: 1=� Phone No. QSC-I 3C) al E- Zip Code: Q4_4 Fax: l�'yL O4• -_ _1D Maik d L-I q Sy Uu acA , c,L,rY\ Phone No-1-10- LAL-PL4 , U0L7b Fill in fee simple Title Holder on next page (if different E-Mail Yr (Ytc e 4-I in Sr1ua-rit)42.,Cbr)S�rU(,�jo-A ) from the Owner listed above) State or County License LA 1`-7 &c)rl 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. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: 0Z_ Not Applicable • U j' Not Applicable Name: >dN-v�oLfl<, 1h 11�G_� Name: I -Ti d-P— ' Address: C DeA •af Address:4CED l i.-tZ City: e-i,— �„ Zip'State:� S !R-1 f Phone: 1� 4(-Di State:(-Pu Zip: 3 P Phone"l'l 9 3�� • p: 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 commencing work or recording your Notice of Commencement. (�L ( C-�U'n �t� Signature o C ntractor-o - caner BuildI s applicable STATE OF LORIDA `' COUNTY OF S--, Lu ru Sworn to(or affirmed)and subscribed befoWme of Physical Presence or Online Notarization this Z day of P_�7 20X 0lby Name of person makink statement. Personally Known .. `OR Produced Identification Type of Identification Produced. T - h (Signature of Not y Public-State of Florida) Commission No. 33�� (Seal) ,y+R Notary Public State of Florida Ginger P Hester y * My Commission GG 330259 *ry w Expires 08l25I2023 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev