Loading...
HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: '. Permit Number: JUL Building Permit Application Permitin9 ST. Lucie County, 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: 5&dress: Act eC Property TaxID#: � ,I 1J Lot No. Site Plan Name: Block No. . Project Name: ILED R11P I • C3 � •ti-cE ���✓� �, t 2�5�cl�n�c� � TL�r-� - New Electrical Meter Second Electrical Meter NS U ! �©� 1C}N• 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: i ER L AE, C T •R.. Name: Address: Company: City: 7-- rC Stater Address Zip Code: JYfS/ Tax: City: State: Phone No. (3655 ��3- 5°7 UP Zip Code Fax: E-MaiL JMG/ddMop(J (Dr Or 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 HAVC is$7,500 or more,a RECORDED Notice of Commencement is required." 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 paying twice for . improvements to your property. A Notice of Commencement;must be recorded 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 len n attorne before commencin work or recording our Notice of Commencement. K S atur Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder TAT OF FLORIDA ` STATE OF FLORIDA COUNTY OFF �d�', (r . COUNTY OF . Sworn to(or affirmed)and subscribed,before me of" 'Sworn to(or affirmed)and subscribed before me of Physical Prese ce or Online Notarization Physical Presence or Online Notarization this day of 2020 by this day of 2020 by Name of 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 (Signaf ure of Notary ublic-State of Florida) (Signature of Notary Public-.State of Florida.) Commission No. KAREN a Commission No. (Seal) ELSEN -State of Florida-Notary Public 3' *_ Commission # G Y CommissionExpires 2, 2 REVIEWS VI OR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW-- REVIEW REVIEW REVIEW REVIEW DATE RECEIVED " DATE COMPLETED ev.