HomeMy WebLinkAboutPermit PackageAll 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 FL 34952 V/
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
Address: ",-)-F'
Property Tax ID #:
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Block No.
CONSTRUCTION INFORMATION: I
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:
Cost of Construction: $_&_3\r1Y"YVn
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic
Windows/Doors
_ Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name i 1
Name:
Address: t4
Company:
nC
City: F- . ! cr-cc State: #L
Zip Code: Fax:
Phone No.
Address: a I (DO 5Lk7
C T API -
City: P, I �_
Zip Code:
Phone No _1_1
State:
Fax:
`"mqn
E -Mail:
Fill in fee simple Title Holder on next page ( if di Atr)'
from the Owner listed above]
E -Mail r
P4) 1
State or County License !:31
1W 31104)
a value oT consirucuon IS Z 4WU or more, a KtcUKULD Notice of commencement is required.
If value of HVAC is $7,540 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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.
1 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."
Signature of Owner/ Lessee/Contractor as Agtnit for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF 5+- L c/C�
STATE OF FLORIDA11
COUNTY OF D. L. f1a�F_
The forgoing instrument was acknowledged before me
this f i day of 1V11— , 20 ?.C' by
The forgoing instrument was acknowledged before me
this � day of 1PX_T L— 20 2(.;Iby
kcj--4k X0 )Cul2
Xedt 1�YY) kelt
Name of person ma ing statement.
Name of person making statement.
Personally Known ' OR Produced Identification
Personally Known f✓� OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida ]
(Signature of Notary Public- State of Florida ]
Commission No. GGIG (Seal)
Commission No. (Seal)
REVIEWS
DATE
RECEIVED
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COUN � /I nmis i� � 876 EVIEW
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Ma Ch 48, 2024
VEGET SEA TURTLE MANGROVE
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