HomeMy WebLinkAboutREVISED BUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date' Permit Number:
-L LL!CLL
t` ' L " -_P Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential V
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: Je V-Frey
PROPOSED IMPROVEMENT LOCATION: } Address: 115 C7 �)�iS RCk / .f `� B JA Ce f f-
Property Tax ID #: - ! A3 - DOO/ - 50 - G Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
/a C. I n ,
o •� its � Q� CIAXn
New Electrical Meter Second Electrical Meter (Affidavit required)
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:r/ N
A- Sq. Ft. of First Floor: /&-
Cost of Construction: $ 2 -1Q0 0 Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name A -Q Name: t
Address: / 5 QI
y. Company: &O'�k_ PLd71 CA /am •
City: a. 1014A C 4_7 State::4_ Address: `/ 7 60, 41 / W
Zip Code: Fax: City: P7 )PI-ede-e State: L
Phone No.E- Zip Code:3yl'g,a— Fax:72)'/�4` AD!V
Mai1:& FVpb01) S0,Rt ;,[g-W - LO ✓ ) Phone No % 7d- EGG- o c>/ 3
Fill in fee simple Title Holder on next page (if different E-Mail 4>�99 . C&,(�
from the Owner listed above) State or County License_ /-3.3 D 71
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.
SUPPLEMENTAL CONSTRUCTIO LIEN LAW NFORMATION:
❑1w5iGNER/E GINEER: of plicable� MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: p 0__r1 -J- m � V Address:
City: cvn~+P State: —�. City: State:
Zip: 0 g P — Zip: Phone:
FEE SIMPLE TIT HOL ER: x Not Applicable BONGING COMPANY: X Not Applicable
Name: Name:
Address: Address: IV I
City: City:
Zip: Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made tc 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 is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners 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 YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU JN D_TG-.OBTAIN FINANCING, CONSULT
WITH T*qk1f4DER OR AN ATTORNEY BEFORE RECORDING YOUR•ND - F COMMENCEMENT."
r ,
re
STATE OF FLORIDA
COUNTY OF ST LUCIE
ntractor as Agent for Owner
The foggoing instr ment was acknowledged before me
this day of 20& by
GARY WHIGHAM
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced
Holder
STATE OF FLORIDA
COUNTY OF ST LUCIE
The folding instrument was acknowledged before me
this !D� day of btAA •vVhVY 20J4 by
GARY WHIGHAM
Name of person making statement.
Personally Known X OR Produced Identification
Type of Identification
Produced
(Signature of N (Signature of -
�.�" Notary Public State of Florida '�' NolAryPuhilC $Ifgl pt Fiw�da
Commission No.mi1y N Nicks{$eal�} Commission N �y N Hickamission HH 0 7541 SeaiExpires 08130I2024 M114Mn HH 037541ar n ""S O813012024
REVIEWS FRONT
COUNTER
DATE
RECEIVED
DATE
COMPLETED
ZONING SUPERVISOR PLANS 1 VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW