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Building Permit Application ,Pitch is missing
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: D '� Permit Number: _ Building Permit Application Punning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Address: Commercial Residential CBDG Funding Property Tax ID #: % "� -- w Lot No. Site Plan Name: tC> .---- V1 Block No.rV, -, - f Project Name: New Electrical Meter Second Electrical Meter (Affidavit required) Additional work to be performed under this permit— check all that apply: Mechanical _,.,, Gas Tank —Gas Piping Electric __.. Plumbing _ Sprinklers Total Sq. Ft of Construction: 45, Cost of Construction: $ (� _ _ utilitie Name U %— c d4, K10 Address: _ e 9- City: � q it State Zip Code: Fax: Phone No. E- Mail• Fill in fee simple Title Holder on next page (if different from the Owner listed above) Shutters Windows/Doors Pond _ Generator X Roof Pitch Sq. Ft. of First Floor: s: Sewer Septic Building Hight: —jL° Name: K I r em (0i, klumnP-7— Company: Dr_-i2 r oIrr G� Address: b City: State: Ef Zip Code: Fax: Phone No E-Mail State or tunty License q01 (� if value of construction is 2500 or more, a RECORDED Notice of Commencement is required. I If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. Name., Address: City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: Not Applicable Name: Address: City: Zip: Phone• MORTGAGE COMPANY. . - Not Applicable Name: Address: City: State: Zip: ----- Phone: BONDING COMPANY'. Not Applicable Name: Address: City: Zip: ___ Phone: CONTRACTOR AFFIDVIT; /application is hereby made to obtain a permit to do the work and installation as indicated. i certify that no work or instaliation nas commemcu pt tvt w L M I-. � .. a rw.....�. St. Lucie County makes no representation that is granting a permit �authorize wsho raid the eiian sit itiia emaybuild r+es rice osubject p ©hibistructure such Ce which conflicts with any appi}cable Homeowners Association rules, y structure. Please consu t 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, accessary 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 pasted on the jobsite before the first inspec�tior.merilf yuniintend Croimt�rcerai� Wit' consult with lender or attorrie oeiore corriiri�ruut ,vvtm Wt 11 �r 41. .,N, ...a.w_ Signature of o t ciar -or - Own r ullder as applicable r � aeooss�a �, p ppCnstalll {p� zz Ci/i1A .AiYi405760 O. 24, 2024 6 EIAgtQl9 STATE 0 FLCiRii A , COUNTY QF Sworn o (or affirme ) nd sub cribed before me of 'kA Physical Presence or _ _ Online Notarization � J this day of (j4a V,�- Name of person making statement. Personally Known OR Produced identification Type de i lion Pr duced P �. (Sin are f of ,ry u lic- St of Florida) Commission No. A D 115100 (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 10/12121