HomeMy WebLinkAboutBuilding PermitAll APPLICA E INFQ MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: F Permit Number:
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��� �' �� Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Address:
Property Tax ID #: - QD,,3- Door C-2� Lot No.
Cita Pian Nama• Rlnrk Nn
New Electrical Meter P� Second Electrical Meter f Ac>
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: tl
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.
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Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
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State or County license CC`,(_. t13
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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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: — Not Applicable
Name:
Address:
City: State:
Zip: Phone:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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 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
WFTH YOUR LENnFR a AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Own ee/Contractor as Agent for Owner
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Signature of Contractor 1cense Holder
STATE OF FLORI
STATE OF FLORI
COUNTY OF
COUNTY OFA
The forgoing instru gnt was acknowledgV#_before me
this day of 73 `-1 2 by
The forgoing instrument was acknowledged before me
this day ofLl� , 2�20 by
_
4ame
Name of per-nmaking statement.
of persoh making statement.
Personally Known OR Produced Identification
PersonaII Known _ OR Produced Identification
Type of1dentification
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Type of } entification
Prod c¢
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(SignatuYe of Notary Public- St Tq PUBS
(Signatu N aryPublic- St t PUBLIC
ATE OF FLOFUDA
Commission No.
=OF FLORIDA
Commission No. 43,0022300
res 914r2=
9J�rd024
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/1/19