HomeMy WebLinkAboutBuilding Permit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
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F Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercia I Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
I PROPOSED IMPROVEMENT LOCATION:
Address
PropertyTax iD #: -4e 2. 501 14,31 000 (5 Lot No,
Site Plan Name: OP Block No.
Project Name: ec n
1. DETAILED DESCRIPTION OF WORK:
7�:zY C rY141-c vio, rAr-,
New Electrical Meter Second Electrical Meter
( CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical , Gas Tank ` Gas Piping _ Shutters i Windows/Doors _ Pond
_ Electric — Plumbing _ Sprinklers — Generator _ Roof IZ. Pitch
Total Sq. Ft of Construction: 2_0aQ Sq. Ft. of First Floor:
Cost of Construction: $ El 2-5 Utilities: — Sewer — Septic Building Height:
OWNER/LESSEE:.
CONTRACTOR:
Name L
Address / �q A)el
Name:
Company:
Add r ss: I559 :�_7 S .
City: State. —
Zip Code: Fax:
Phone No.M2_ LP�2J (0 Z(Qg)
City 4 Lt.c.0 � State:(
zip Code: Z Fax:
E-Mail:
Phone No ��� (D 21 t 1 p,_
Fill in fee simple Title Holder on next page ( if different
E-Mail
from the Owner listed above)
State or County License _ /=�2& 7�'
!r value or 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:
DESIG NER/ENG I NEER: Not Applicable MORTGAGE COMPANY. Not Applicable
Name: Name:
Address: Address:
City: State: City: -State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City -
Zip:
NotApplicable
BONDING COMPANY: Not Applicable
Name'
Address:
Zip: Phone:
OWNER/ CONTRACTOR AFR0VITApplication bhereby made uzobtain apermit tn6nthe work and installation noindicated.
| certify that oowork minstallation has commenced prior to the issuance of a permit.
St. Lucie CountV makes no representation that is granting a permit will authorize the permit holder build structure
which ." conflict with any applicable Home Owners Association rules, bylaws o,onmcovenants prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
|nconsideration ufthe granting ufthis requestedpermit, |dahereby o that | will, i 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 tnanother non-residential use
WARNING TOOWNER: Your failure toRecord aNotice mf Commencement may result impaying 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 attornev before commencing work or recording vour Notice of Commencement.
of O�ner/ Lds—sei/Co-ritractbi, as Agent for Owner Signature of contractor/License Holder
STATE OF FLORIDA
2STATE OF FLORIDA
COUNTY OF— 5f COUNTY OF- ,
Sworn t r affirmed) and subscribed before me of Swor ffirmed) and subscribed b
_�z-ral Presepce or Online Notarization V?P<th1ys(i0cralaireMce or Online
Name of person making statement.
—OR Produced
-
"Name of person making state�,
ProducE
Cr
(Signature m* iz)o Tt
- 0-
Commission No. (Sea) T, �
(Signature of
Commission No.
Of
-
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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