HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �(
Date: Permit Number:
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JUL 0 8
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Building Permit Application
Planning and Development Services ST. Lucie County Permitting
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
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Address: 2 70 SW A�'I o:S bj o - PSL � � ��- ��C.�G/2 3
Gf �`� �- 7 S- �� Lot No.
Property Tax I D#:��� ��
Site Plan Name: Block No.
Project Name:
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New electrical Meter Second Electrical Meter
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: $ 9L 4 G0 Utilities: _Sewer _Septic Building Height:
Name L Name: .
Address:81 0W t 1'� 1 1 Company:
City: S State. E Address:
Zip Code: 3L(a( 83 . Fax: - City: State:
Phone No. 60 - -r 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 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 TITLEHOLDER: Not Applicable BONDING COMPANY: _Not Applicable
'Name: -- Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
hereby made to obtain a permit to do the work and installation as indicated.
OWNER/CONTRACTOR AFFIDVIT:Application is he y
OW / PP
I certify that no work or installation has commenced prior to the issuance.of a permit.
ize the ermit holder to build the subject structure
that is.granting a permit will authorize un makes no representation t g
w Lucie Co P n P - pp restrict or prohibit such
bylaws or and covenants that may rest p .
ty Association rules Y .
which is in conflict with an applicable Nome Owners As ,, y
Y. PP deed for an restrictions which may apply.
structure.Please consult.wrthyouurHgme Owners Association and review your d y
In consideration of the granting of this requested permit,f do hereby agree that-I will,in all respects,perform the work
roved tans the Florida Building Codes and St.Lucie County Ame
ndments.
with the a g in accordanceP ,
PP
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 lender or an attorney before commencing work or recording our Notice of Commencement:
Sig ture of Owner/Les ee/Contractor as Agent for Owner Signature of Contractor/License Holder .
STATE OF FLORIDAt, STATE OF FLORIDA
COUNTY OF �� �Id1(',lt' COUNTY OF _
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
ysical Pres nce or Online Notarization , Physical Presence or Online Notarization
this day of 20_ by this day of 20_ 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 o Produced
K REN S.. NIELS
o
ublic-State of Florida ofNota u ic- - tate ? a2N
Co m onG � g )
FoFF�oe: My Commission Exppires -•
Commission No. al) "� "� ConiisSi;itP2Jo. _(Seal)JUL
(Seal) .
I_ 0 8 26h .
ST. Lucie County,:Permi ing
REVIEWS. FROM ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.