HomeMy WebLinkAboutBuilding permit application
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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 Commercial __________ Residential ___________
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: __________________________________________________________________________________________
Property Tax ID #: _________________________________________________________________ Lot No.__________
Site Plan Name: __________________________________________________________________ Block No. _______
Project Name: ______________________________________________________________________________________
DETAILED DESCRIPTION OF WORK:
New Electrical Meter __________ Second Electrical Meter_______________
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit – check all that apply:
__Mechanical __ Gas Tank __ Gas Piping __ Shutters ___ Windows/Doors ___ Pond
__ 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 HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
Address:
city: State:
Zip:—Phone—
FEE
ip;PhoneFEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
MORTGAGE COMPANY: — Not Applicable
Name: -
Address:
City: State:
Zip; Phone: —
BONDING COMPANY: _Not Applicable
Address: Address:
C ty: City.
Zip: Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFIDVfT: Application Is hereby made to obtain a permit to do the work and installation as indicated.
(certify that no work or InstaVation has commenced prior to the issuance of a permlt.
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 Aswc-ation rules, bylaws or and covenants that may restrict or prohibit such
ich may apply.
structure. Please consult with h your Home Owners Association and review yodeed for any restrictions wh
In consideration of the granting of this requested permit, I do hereby agree that t will, in all respects, perform the work
in accordance with the approved plans, the Florida Suilding 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.resuft in paying twice for .
improvements to your property: A Notice of Commencement must beikbrded 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 attorMybefore commencing work or recording our Notice of Commencement-
STATE
ommencement
STATE OF FLORID
COUNTY OF (� E
Svrgrn to (or affirmed) and subscribed before me of
iX Physical Presence or Online Notarization
thMS day of :Tt 1nP 2020 by
Name of person mkir,astatement
Personally Known OR Produced Identification
Type of identification
Produced
(Signature of Notary Pubgc- StatteOr F:anda )
Commission No. LLa(P (seal)
STATE OF FLOR�DA
COUNTyOF
S rn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this J� day of - O 0 .2020 by ,
Name of person making tatement
Personally Known OR Produced Identification
I Type of identification
(Signature of Notary Public- state% of Florida )
Commission No.Z I -P (Seal)
REVIfiWREVIEW REVIEWON 5 REE MANGROVE
WS CON VIWIREVIEo R R
Notary Pudic Stale of Florida
Nicole K Velardo
My Commission GG 926226
Expires 11/178023
My Commission GG 926226
Expires 1 V17r2023