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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED d Date: ,3 U �� Permit Number: RECEIVED r- MAR 2 L'022 � :� .:• : ° -•....._ :�.� Building Permit Application at. UU100�,wnj� �er't�ilttii�g Planning and Development Services / Building and Code Regulation Division Commercial Residentialy 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: S gi Address: ..14'�'fl�.�e'"'IJ<9✓e— Pvl+ S�lrl% Property Tax ID #: �L�6 J�4 © / �6oD '� Lot No. Site Plan Name: A Block No. Project Name: 0"2� Shed 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 _ Shutters _ Windows/Doors _ Pond Electric Plumbing _ Spririklers _ Generator _ Roof Pitch _ _ 114 Ft. Total Sq. Ft of Construction: ' Sq. ,of First Floor: Cost of Construction: $ ��� �d Utilities: _ Sewer _Septic Building Height: gs -Name �ii IiJ:y� .Warne:# " L Address: J�CD a •7 12 ? :'[i-�+. =Y VCompa'py: City: �O/ �q��i✓ G/:R Y,F State':t/ °Artcls"s: City: 1 State: Zip Code: /� Fax: Phone No. % 07 — / r 31' Zip Code: Fax: E-Mail: � C(_ /"v 2 D )4 - Gd/y/ Phone No Fill in fee simple Title Holder on next page ( if different E-Mail from the Owner listed above) State or County License 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. law Nam - MEN DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Applicable Name:' ZIA/e a1 /—G G _L,�-Illot Name: Address: �O' `/ - D,A)fY%ew R04 -e Address: City: — State: C Zip: 3V 3 .. Phone �0.2-�o1/-y�37 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 pemm,it 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 orprohibit 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 Noticdof 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 fhe first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording our Notice of Commencement. Signature of Owner/ Lessee/Contractor as Agent for Owner STATE'OF FLORID) [ I_` ��� COUNTY OF J�" Swor o (or affirmed) and subscribed before me of Physical Presence or Online Notarization this an day of t`&Ar'C�N 20,aby Name of person making statement. Personally Known O.R Produced Identification Type of Identification Produced 17t�tiC� I,,; �.etiLs' (Signature of'Notary Public- State of Florida . ...... CATHY MICHELLE JERGER s Notary Public - State of Florida Commission No. L��7 + + [ (Seal) +®ea Commission # GG 98107 )oF My Comm. Expires May 11, 2024 Bonded through National Notary Assn. REVIEWS FRONT COUNTER ZONING REVIEW SUPERVISOR REVIEW PLANS REVIEW VEGETATION REVIEW SEA TURTLE REVIEW MANGROVE REVIEW DATE RECEIVED DATE COMPLETED . Rev