HomeMy WebLinkAboutVoid-Building Permit Application 9-22-21. _ . i,
_
All! APPLICA LE'IN. F 'MU..ST BE.COMPLEToD FOR APPNCATION TO: BE ACCEPTED 1 A
JU =PermitNumber!
DaL UO 0 4 LI I i all
w
o� q -
�l
Bailding'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) 4,62-1578MG Funding
PERMIT APPLICATION FOR;
Address:
Property Tax ID #:
Site Plan Nam
Project Name.
I
I
:► 'Sy4"-
Lot No.
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
Electric Plumbing _Sprinklers _"Generator
Total Sq. Ft of Construction' 7. Sq. Ft. of First Floor:
Windows/Doors: Pond
Roof ... Pitch
Cost of Construction: $ I r -Utilities: —Sewer _Septic. Building Height:
OjNNER/LESSFE �>
�k,....�. �+a.. ..rn,,• ,. %�. ,72. .� :t�.. .�.
51��5.2
r�
.w,• rK. �... ;{.�;.r�:K5 �.. �. d. F`7 X<.. z. .,.zi; f _n.. .�", ra
LU
ra
Name
Name:,
Addres "°1 Z,
Company:
CV
City: State T
Addre -
.'
�;
Zip Code: � Fax:
IWT
_ .
City:
State:
Phone No. 1 E-
Zip Code, —Fax
Mail: :. dC o^
Phone No.
Fill in,fee simple: Title Holder on next page ,(Ifdifferent
'E-mail
from the Owner listed above)
State. or County License
IIff value of construction is 2500 or more, a KtGUKUtV wotice or commencement m. requircu. I
lfvalue of HAVC is $7;500 or more, a RECORDED Notice of Commencement is required.
�,������4�1■�A� ��N��������C�� �. ���4ft'��t��Y
DESIGNER/ENGINEER:Applicable
MORTGAGE CAMPANY: ,_Not: Applicable
Name:. _ ...
Name':.
Address.;
Address
City:
OWNER/ CONTRACTOR AFFI..DVIT:.Application is hereby made.to obtain a, permit to do the:work`andrnstailationas'mdreated.
I certify that no<work or installation: has commencedprior to the issuance of a permit.
St. lucre County makes no::representation that is granting a Permit:wiltauthorize the permit holder to build the subject structure.
which conflicts with an�y..applicable: Homeowners Association rules,.bylaws or and covenants that may restrict,or prohibit such
structure. Please consultVurth your Homeowners Assoaatign:aind' reviewyour deed for any testrictions which may, apply;
inconsideration of thegrant ng of this:requested;pertrilt� I do hereby agree that I will, in'ati respects;. perforin.the:work'.
in accordance: with the.approved plant,,. -the. Florida Building Codes, and St,., Lucie County Amendments'..
The.following building.permit appltcatioris are exempt'frorn undergoing a fulHoncufrency:review: room additions;
accessory structures; swiniiming pools, fel ces, walls; signs, screen rooms acid accessory uses to. another non residential use
WARNING TO OWNER: Yourfailure to Reco..rd=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 attorne y °before comme work or'r'ecording 'v our Notice of Commencement:
ev
State,
lvXK
i
Signature of Own. as Agent tor'Owner
T-66ee/Cdhtreicrtor
STATE OF FLORID
COUNTY OF
Sworn to or affir <ed) and ubscrtbed befQ a me
of ,,Physical Presence. or Online Nota.riatton
Dame of person:. makingsta ent.
..
Personally Known OR.Produeed identification
Type of'Ide lfication Produced
(Signature of Notary PublicSfate of,Florda---
"
Commission! No. %__>U0 Seal).
T11'�P BRiCGS
��,Y Public,
r r' wuCG2U:r?�Sc�.3 '
a fzc,�: tvlvy'�2 �022
REVIEWS
FRONT
'.ZON1t�G:
SUPERVISOR'
;PLANS
VEGETATION
SEA TURTLE
MaIVGROVE
COUNTER
REVIEW
<
REVIEW
REVIEW"
REVIEW
REVIEW
REVIEW
.....DATE
RECEIVEQ
_._.......
.
DATE
.
COMPLETED'