HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO
�MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7i3 !iZ
Permit Number:
g`Uo Lure - .
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:
PROPOSED IMPROVEMENT LOCATION:
Address: �ILrF� C-fNA
Property Tax ID #:
J�� � � �� � ' � Jl x� ' � Lot No.
Site Plan Name: 1 Block No.
Project Name: e" I r\
DETAILED DESCRIPTION OF WORK:
rullW"o_ P�c'�s�i�ncr Oto rr
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
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: $ -7,D d-7 . I J Utilities: —Sewer _ Septic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name r M,1(J (nt �Sm �mn
Name: )Oyyp1l
Company: II)p �ilI n <h j(
Address: r/I IQ cC1 +,
^^LAC
City: Rv:N-Vie- y-k StateJ-- L-
Zip Code:? QnB L Fax:
Phone No. E-
Address:
City: State:
Zip Code: Fax:
Fax:
Phone No 1�2' �011,' SONS"
E-Mail \b -IrMm Ci
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License Cf-W, _ ZSQ
bvunntMUM"enk IS requlrea.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DE ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name: _
Address:
City: T
Zip:
Phone:
_4Not Applicable
v rr.v nm%-v %in mrriuvi 11: Appiication 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, 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 atternpv hPfnra rnmmnnrina.e,nrL — -..,,..A:..,...,..._ _r,
Signature of Contractor - or - Owner Builder as applicable
STATE OF FLORIDA ,
COUNTY OF_
Sw r%o (or affirmed) a_9d subscribed be me of
this day
Physical Presence or Online Notarization
0 of,
Name of person aking statement
Personally Known OR Produced Identification
Type Produced
Rofdentific4tion
4 �
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%Signatures f o Public- State of Florida)
'qs• " MY COMMISSION #HH199309
` EXPIRES: DEC 04, 2025
Sion No.(Seal)
` Bonded through 1st State Insurance
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