HomeMy WebLinkAboutBuilding Permit App - Ed StewartAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: +"di deq .3 : L614 -,L_ Permit Number:
b.
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:
PROPOSED IMP
Address: i�-, 7 Y£ tQ,
Property Tax ID #: _ yt,
Site Plan Name:
Project Name: im-r ,
Pd'A l C
MENT LOCATION:
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_XEJ*J 1L%t.�{6 t`!_ ! o-.i r1 [ L�J
.1 FE.UI.L JAI- —A L L
I- P L) z iCZ6-Atc-
DETAILED DESCRIPTION OF WORK:
New Electrical Meter
Lot No. '�;
Block No.L
/A%.S &IL- lb , 1"Jf LL t%tJ✓riles' fcr -!L
Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
Additional work to be peiformed under this permit - check all that apply:
Mechanical ;Gas Tank Gas Piping Shutters Windows/Doors Pond
— Electric —Plumbing — Sprinklers — Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ ¢l, 9-40 L) Utilities: —Sewer —Septic Building Height:
OWNERAESSEE:
l �-
Name uai:_(ernA&
Address:
City: P4.,- _f�- Luc, i
Zip Code:.,?N V-6--2-
Phone No. V4o R 27
Mail:
Fill in fee simple Title H(
from the Owner listed a
CONTRACTOR:
Name: Ilscn-« I,rLY
Company: h 6-tLtitT /`tAwL
State: FL Address: 2Sl xiij
_ Fax:
dYssmL .L� �y
ler on next page (if different
ove)
City: i'fl.s f S`. L ue,4: State: �L--
E- Zip Code: ..'SIs-fL- Fax: -772 -,9i4. -lee 0277-
Phone No '77Z. S3 1 z rD 4 1_3
E-Mail #.UF'4 0- raC'r�cYl`�rr:rcG Ly ice.,
State or County License C &.c r-r2 7 s'7 i
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
DESIGNE
Name: _
Ad d ress:
City:
Zip:
NGINEER:
NSTRUCTION LIEN LAW INFORMATION:
Phone
FEE SIMPLE TITLE HOLDER:
Name: I
Address:
City:
Zip: Phone:
Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
State:
— Not Applicable
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTO.2 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; nd p sted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender o an ey bpfore commencing work or recording our Notice of Commencement.
Signature of C rack v- or _ Owner B�ilder as applicable
STATE OF 0RIDL ((//
COUNTY OF - I�
Sworn tp (or affirmed) an subscribed before me of V Physical Presence or Online Notarization
this�day of , ZtT� by
Name of person making
gsstatement. t
Personally Known V OR Produced Identification
Typ_e of Identification Produced
(Signature %f Notary Puublic- State of A a)
Commission No q Seal}
� 0 Notary Pub#ic State o4 Florida
Crystal E Naylon
My Commission GG 929549
Expires 11/06/2023
REVIEWS FRONTS ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
SUPERVISOR PLANS VEGETATION SEA TURTLE I MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW