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HomeMy WebLinkAboutBuilding Permit Application--Bates WindowsAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 2 Permit Number: NJ Uo L,1L�t1L5 O if 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: �e.O�NC�&Y I 1 PROPOSED IMPROVEMENT LOCATION: Address: Property Tax ID #: Site Plan Name: Cin Project Name: 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 — Windows/Doors _Pond _ Electric _ Plumbing — Sprinklers _ Generator Roof .— Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $�l ��Q n© Utilities: _ Sewer _ Septic Building Height: OWNER/LESSEE: CONTRACTOR: (Affidavit required) Lot No. Block No. C rs_ Name L Y lr' Addre City: V �4 State: Z Zip Code: ax: Phone No. E- ntail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) State or County Licenset�n(1, 1 -14 )t':5 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. SUPPLE -MENTAL CONSTRUCTION LIEN LAW INFORMATION: 1 DESIGNER/ENGINEER: _ Not Applicable Name: Address: City: Zip: Phon State: MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: 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 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, w s, signs, screen rooms and accessory uses to another non-residential use WARNING TO OWNER: Your failu Reco a Notice of Commencement may result in paying twice for improvements to your pro A Noti a of Commencement must be recorded in the public records of St. Lucie County and pod a obsite before the first inspection. If you intend to obtain financing, consult .with lonrlor tar tan n tar o fn a rnm onrina work nr recording your Notice of Commencement. gn a of Con or - or - Owner Builder as applicable STATE OF FLORIDA COUNTY OF Sworn o (or affirmed and subscribed beyme of Physical Presence or Online Notarization f this i day of 2(L� by Name of person making tatement. Personally Known OR Produced Identification Type of Identification Produced (Signature of Notary Public- State of Florida Commission No. (Seat)y,n Notary pualc Stale of Florida Petrick A Romeo 4 My Commission GG 264001 V Expires 10I01*022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev