HomeMy WebLinkAboutBuilding Permit ApplicationAIIAPPTICABLE INFO MUST BE COMPTETED FOR APPTICATION TO BE ACCEPTED
Date;3-21*2 Permit Number:
sit: Luct,l"lrrot(#7)/ -lv 7-3lo
r lr Building Permit Application
Planning ond Development Seruices
Building ond Code Regulation Divisian
2i00 Virginia Avenue, Fort Pierce FL j4982
Phone: (772) 462-T:553 Fax: (7721462-L578
Commercial Residential
CBDG Funding
Address:7rE B/,frrtf ent c/,3r r7
Property Tax lD #
Site Plan Name:
//To2-
'o/
- 070q - 000- 7 Lot No 7tr
t Block No
Project Name 7/v
a4 / frort/-rntr)).h
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION I NFORMATION :
Additional work to be performed under this permit * check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors Pond
Pitch_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof
Total 5q. Ft of Construction:T,2 Sq. Ft. of First Floor:,v2
Cost of Construction: $/7oC.oo Utilities: f(5"*", - Septic Building Height rff
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
lf value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
PERMIT APPLICATION FOR: Qemo /r-y';on
PROPOSED IMPROVEMENT LOCATION :
't7)c 'c{a a
OWNER/LESSEE:CONTRACTOR:
Phone No. 8i'3 - 8C '- ,{
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State &
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3
zip
City:
rA /er
code: j3l t"7 Fax:
Address
Name
P-/ne lfo Bov
7qLlO f ,n/. lz
il7{7 rax:77)'272-2/?/
Phone No 7V2",210 -77,'f
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State or County
17
ny
Zip Code
State: fr--
Name:
Compa
,Y
Address:
City:
Phonezip:
DESTGNER/ENGTN
Address:
Name:
City:City: , State: _
ress:
Phone:zip:
Phone:
Not Applicable PANY:_Not Applicable
Phone:
Address:
Name
City
zip:
OWNER/ CONTRACTOR AFFIDVIT : Application is hereby made to obtain a permit to do the work and installation as ind
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Countv makes no representation that is erantins a permit will authorize the oermit holder to build the subiect structure
which conflicts with anv applicable Homeownersassocialioh rules. bvlaws or and coVenants that mav restrict or or6hibit such
structure. Please consult With your Homeowners Association and review your deed for any restrictions which may apply.
ln 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 ite before the first inspection. lf you intend to obtain financing, consult
with lender attorn m nctn or recordi r Notice of Commencement.,*ofgc
of Contractor - or - Owner Builder as applicable
STATEOFFLORIDA /'yJ ^ ^ t .,couNwoF /t /ftlt',tl
Su/orn to (or affirmed) and subscribed before me of
*isJlL4ay or Nli+tZt-tq-- ,zoUlby
M-or, -(^,fi-
Physical Presence or _ Online Notarization
Name of person making statement.
Personally Known OR ification L.--
Prod V
otary Public- State rida)
Commission No.(Seal)."r:ll.il% JESSEDoSS
. -ha# * Commtsston # GG 263069
?tpJ[ryi Expires Seprembe r 27, 20ZZ''f
65 p1o$ Bondqd lhru Budg€t Nolary Sgrvlces
REVIEWS FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
CONSTRUCTION LIEN LAW INFORMATION:
_ Not Applicable