HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a"a Permit Number:
Building Permit Appli
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1518
PERMIT APPLICATION FOR:
Address:
JUN 2 9
ti� S
0T. Lucie Coun ty Permitting
Residential
Property Tax ID #: W f — " M7 it ^ 000 2' Lot No.
Site Plan Name: Block No.
Project Name:
New electrical Meter Second Electrical Meter
Additional work to be performed under this permit— check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters
_ Electric _ Plumbing _Sprinklers
Total Sq. FtofConstruction:
2ab S�F�
Cost of Construction: $ 3 5 8a,0
amm
_ Generator
Sq. Ft. of First Floor:
Windows/Doors _ Pond
Roof Pitch
U
tilities: _Sewer _Septic Building Height:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Address Z- :,._ . .
4.
City: State:_
Zip Code: Fax:
Phone No
State or County
if value of construction is 2500 or more. a RECORDED Notice of Commencement is
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
0.
Name:
Name:
City: State:
City: State:
FEE SIMPLE
Name:
Name:
Address:
Address:
City:
City:
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 priorto the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holderto 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
improvementsto your property. A -Notice of, Commencement must be recorded iri 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 attorneybefore commencingwork or recordingour Notice of Commencement.
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Address:
Address:
1 Phone
I Phone:
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• Applicable
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ignatt ".miner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder .
STATE OF FLORIDA
STATE OF FLORIDA ,
COUNTY OF Sk . Lu c�2
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Presence or_ Online Notarization
Physical Presence or ' Online Notarization
_Physical
this 'a.�day of c� Jrn� , 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 � � s
Produced
t� .ene rs
Produced
(Signature of Nota rf"�is�te o�¢�Ip(U5$ION #GG o22023
(Signature of Nota