HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
s °
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce F64982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
if
PERMIT TYPE:
PR'Q 'O;ED IMI 170A,EMENT Lt3CATIH3
r
Address: / - 7r7 o Z-
Property Tax ID#:-,- )yZ D -1?V z -ooa3-- " ao- Lot No.—
Site Plan Name: Block No.
Project Name:
I� I
JI[
DETAILED DE=SCRIP ION OF WORK:
o r
I
I
OM MTRUCTIO L FU MAT ®N:
i
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ 20C Utilities: -Sewer Septic Building Height:
01NNER/L=SSE CONTRAC tJR:
Name > I Name:
Address: ® 'z 1 fh f2�Z, ,,Aje. C�1 Company: c e- n (-
City:P�1r�S'�!-.UGJ e-, State: Address: r�. e e Y IY-0,
Zip Code: 41�� Fax: City:,�CZ�Z 2.yc_s e- State: -Ivrz.°
;Phone No. 2 9 Zip Gale: mil. Faz
E-Mail:
'Fill in fee simple Title Holder on next page if different E=Mail60
..„:'_�f.lL:a'+3:?._.-�-•^a%:• :�:
from the Owner listed above) State or County Lic rise
it
Ifvalue of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
Sl1 RLEMEN AL CaNSTR CTI�N LIEN LAW IN=@RMT1@
DESIGNER/ENGINEER: _N.ot Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone 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 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
INOTNEBEFREFCRGOUTOT EOFL INSPECTION. AATORYO FINANCING CONSULT
YOUR NOTICE
COMMENCEMENT.
S' natur 6f Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA _ STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledg before me The forgoing instrument was acknowledged before me
thi day of ASV by this day of ,20_ by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identificatio` Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public-State of Flori (Signature of Notary Public-State of Florida)
Commission No. �!:« .#: LAS N#GG2T5050 Commission No. (Seal)
EXPIRES:Decen*00,2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED