HomeMy WebLinkAboutBuilding Permit Application (notarized)All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ____________________ Permit Number: _____________________
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial ________ Residential ________
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: __________________________________________________________________________________________
Property Tax ID #: _________________________________________________________________ Lot No.__________
Site Plan Name: __________________________________________________________________ Block No. _______
Project Name: ______________________________________________________________________________________
DETAILED DESCRIPTION OF WORK:
_________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
CONSTRUCTION INFORMATION:
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: $ _____________________ Utilities: __ Sewer __ Septic Building Height: __________
OWNER/LESSEE: CONTRACTOR:
Name__________________________________________
Address:________________________________________
City: _________________________________ State: ___
Zip Code: ______________ Fax:____________________
Phone No.______________________________________
E-Mail:________________________________________
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name:_________________________________________
Company:_______________________________________
Address:________________________________________
City: ______________________________ State:____
Zip Code: ________________ Fax: __________________
Phone No_______________________________________
E-Mail__________________________________________
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.
X
FL
3-20-2020
X
low voltage permit
2900 Industrial 33rd Street
2900 Industrial 33rd Street
1428-702-1501-000-1
Treasure Coast Auto Auction
Low voltage electric fence as authorized by Florida Statute 553.793
4000
Davcon Properties LLC
Davcon Properties LLC EGD, LLC
5500 Sand Lake DR EGD, LLC
Melbourne, 550 Assembly St., 5th Fl
32934 Columbia SC
29201
803-201-1773
dmclellan@amarok.com
EG13000510
SUPPLEMENTAL CONSTRUCT ION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address : Address:
City: State: --City: State: --
Zip: Phone Z ip: Phone:
FEE SIMPLE TITLE HOLDER : _ Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City : City:
Zip: Phone: Zi p: Phone :
OWNER/ CONTRACTOR AFFIDVIT: App lication is hereby made to obtain a permit t o do the wor k and installation as indicated .
I certify that no work or installation has commenced prior to the issuance of a permit.
St. _Lucje _Countfl_makes no repre~entation that is granting a permit will authorize the permit holder to build the ,subject str_u~ture
w hich 1s m con l1ct with any applicable Home Owners Assoc1at1on rules, bylaws or and covenants that may restrict or proh1b1t such
structure. Please con sult w ith your Home Owners Association an d review you r deed for any restrictions wh ich may apply.
In consi deration of the granting of this re quested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Fl orida Building Codes and St. Lucie Co un t y Amendments.
The following building pe rmit appl ications are exempt from undergoing a full concurrency review: room additions,
accessory structu res, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residentia l use
"WARNINC TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYINC
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 FINANCINC, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of 'l::o nt ijt o r/Li ce n se Holder
STATE OF FLORIDA STA TE OF~GftlOA ~ ~L..J/\JA
COUNTY OF COUNTY OF L;c~ t-J,(s~
The forgoing instrument w as acknow ledged before me The ~g instrument was acknowledged before me
t his __ day of 20_ by t his ay of tuH.U-\ , 20.W by
Name of person making statement. Name of person making stat ement.
Personally Known OR Produced Identificat ion --Personally Known ~ OR Produced Identi fication
Type of Identification Type of Identification
Produced ''°V~
(S igoat,ce ~e of -)~µ, \ (Signature of Not ary Public-State of Florida )
Co m miss ion No. (Seal) Commiss i on N~~-rAROL BAw'!JINGER
~\II.~ I NOTARY PUBLIC .. --• -. 1:--"~~· ,,-'-~•-VI ---'"' -·-~:-·n ~i ~GROVE REVIEWS FRONT ZONING SU PERVISOR PL ANS ~ R ,l?20,
COUNTER REVIEW REVIEW REVIEW ,~ . .u -REVIEW
DATE
RECE IVED
DATE
COMPLETED
~ev. 2/7/19