HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Iwo Permit Number: .�
Building Permit ApplicatiomN.-''
Planning and Development Services
Building and Code Regulation Division o°d�
2300 Virginia Avenue,Fort Pierce FL 34982 !✓�
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential /
PERMIT TYPE:
PRQPOSEDIMPRQVEMENT I.QCATIQN
Address: �� 1 Irk
Property Tax ID#: `�( JAI I S2Wo Z Lot NoN-7 2,'S
Site Plan Name: Block No.
Project Name: u
ts
C?ETAILEC 'DESCRIPTION"OF" 'Q K.'.'
sMALI VEffd ELI I Mie
C� aina
NSTRUCT;gN INfQRMATIO,N s ,
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Additional work to be performed under this permit-check all that apply:
Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator -�Ooof =IZ Pitch
Total Sq. Ft of Construction: � _ Sq. Ft.of First Floor:
Cost of Construction: $ Utilities: —Sewer _Septic Building Height:
C7UVNER/LESIME COtUTRACTQR,
A
Name. Name:
Address: Company:
City: State: Address:
Zip Code: Fax: City: State:
Phone No. Zip Code: Fax:
E-Mail: 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 HVAC is$7,500 or more,a RECORDED Notice of Commencement is required. 501r ��
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SUPPLEMENTAL CONSTRVCTIO LIEN LAW 11V aRIV(AT1�N r
DESIGNER/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 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 INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Sign atu of Owner essee%Contractor as Agent for Owner SignAur ur of Con ctor/License Holder
STATE OF FLORIDA, STATE OF FLO DA
COUNTY OF inata in / COUNTY OF
The fi�g in ment was acknowledge before me The forgoing instrument was a knowledg before me
this 'day of 20 by this-JT day of 20 by
a 6
Name o person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known_ OR Produced Identification
Type'of Identification Type of Identification
Produced Produced
(Sign f • t r r PPubb c StatFlorida) (Signa re of Notary Public-State or-Florida)
Notary Public State of Fbrida (Seal)
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Commis otR �� , II ,Jeal Commission No. p Seal
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MY COMMIX, 8Q 3
REVIEWS' FRONT ZONING SUPERVISOR PLANS VEG
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COUNTER REVIEW REVIEW REVIEW REVIEW V&JE VI
DATE
RECEIVED
DATE
COMPLETED
Rev.