Loading...
HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE/INFO/MUST BE ;COMPLETED FOR APPLICATION TO BE ACCEPTED I Date: ! i Cam I Permit Number:. 'J U. F-LLd I C 0E j �- C1 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 PERMIT APPLICATION' F;IOR: Peic r I Property TaxlD#: �� ���`�djj�'� Lot No. Site.Plan Name: q lupCll,a Block No. Project Name: . - Y !De,nd [ I 1 i o A Le 6 f r1 el, 1 pO�e Rd ,iO 4' n,,� .4�n Y,o�! tlCtrcf Am) � rv�e1?1" !0'V'''Zli 6,YY>6 1'k zX;`-(I f o k-e-1S crl,e'( f • New Electrical Meter- Second Electrical Meter (Affidavit required) ffi- - V 'r'� ffi01M. -fie'.' . ... _. --� t.. - <" Additional work to be performed under this permit —check all that apply: _Mechanical Gas Tank _ Gas Piping _ Shutters -Windows/Doors _ Pond Electric _ Plumbing _Sprinklers _ Generator _ Roof Pitch I Total Sq. Ft of Construction: i Sq. Ft. of First Floor: k Cost of Construction: $ 4 100• ` Utilities: —Sewer ._Septic Building Height: - I Address:- 75�5 �'vr�rit,:n>Pci ��e Company: /� ,'� ' City: �r-� Prarc.-c , I State: �L Address: / � 5 City: 5 Stater Zip Code: '34 15/, Fax: Phone No. 9,57 (0;za 7115 Zip.Code: Fax- E-Mail: 11 u 141.16 6 10,44- ("A. Phone No ' )Self)- 97 Fill in fee simple Title Holder; on next page ( if different E- r VJ4 -�eelecjr«q,,We7,,r1 State or County License ECI from the Owner listed -above) 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. I y4'W arm a DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not7Applricable 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-perrmit 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 fog 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 atto e before commencin work or recording our Notice of Commencement. Signature of Owner/ Lessee/Contractor as Agent -for Owner STATE OF FLORIDA COUNTY OF Sworn to (or affirmed) and subscribed before me of _ Physical Presence or Online Notarization this day of 20_ by Name of person making statement. Personally Known .OR Produced Identification Type of Identification Produced (Signature of Notary Public- State of Florida ) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW .REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 2 2 I MORTGAGE COMPANY: Name: _ Noi:A. pplicablel DESIGNER/ENGINEER: Not Applicable Name: Address: Address: - City: Zip: Phone State: City: Zip: Phone: States FEE SIMPLE TITLE HOLDER:; Name:- _ Not Applicable . BONDING COMPANY: Name: Not Applicable` 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 id paying twice for improvements to your property. A Notice of Commencement must be recorded in the public records of St Lucie County and postedlon the jobsite before the first inspection. If you intend to obtain financing, consul, - with lender or an attornev before commencing work or recording your Notice of Commencement. l f Signature of Owner/ Lessee/Contractor as Agent for Owner I STATE OF FLORIDA COUNTY OF Sworn to or affirmed and subscribed before me of r' Physical Presence or Online Notarization ;� ( ) i this .t day of d�1v1�2_, by-- Nameame of person making statement. Personally Known OR Produced Identification Type of Identification Produced' 7A)CU (Signature of Notary Public- State of Florida.) Commission No. • `7 (Seal) i REVIEWS FRONT ZONING COUNTER REVIEW DATE RECEIVED DATE COMPLETED Rev 2 2 ELLEN VAUGHN _State of Florida -Notary Publi Commission # GG 270079 idly Commission Expires SUPERVISOR I PLANS I VEGETATION REVIEW REVIEW REVIEW :ATURTLE MANGROVE REVIEW I REVIEW