HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: `1' ��` —oo Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce F134982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address:
Property Tax ID #:
Site Plan Name:
Project Name:
New Electrical Meter
Second Electrical Meter
Lot No. (0
Block No. o �p
C yro� I
Additional work to be perf rmed under this permit— check all that apply:
nical l
_Mechaas Tank ZGas Piping _ Shutters _ Windows/Doors _ Pond
�lectric _Plumbing _Sprinklers _Generator Zoof 441 Pitch
Total Sq. Ft of Construction: !3W Sq. Ft. of First Floor: 000 -V—
Cost of Construction: $ oc)Q Utilities: -Sewer _Septic Building Height:
Name ` V k. ync�—f�?
Address: a0 ' Nv' Q z .0 4 Q W"City: P[5.:.`m 1 State: C_
e
Zip Cod:' `3L�-q'q Q Fax:
Phone No. ,`;v`
E -Mail: CkM LV1?4Y(?,a--lt0,ACL0(A l�.(6Ai 0
V�
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Com pa
City:
State: _iE—
ZipCode: '34991 Fax:
Phone No'r(2� �A(OU'3
E -Mail 91lxr\ i CYV�P.0-4i�"P l �ef�YYtCt��,G'eA
State or County License C aQ E0 QL
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
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address: r /? _
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address: Ila,
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 TOO NER: Your failure to Record a Notice of Commencement may result in paying twice for
ro e en s to your property. A Notice of Commencement must be recorded in the public records of St.
L,vacle' my and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
ith f er r an attrirnow before commencing work or record irl- oG Notice of Commencement.
i t re o n r/ Lessee/Contractor as Agent for Owner
Signature of Ca tractor/License Holder
STATE OF R�A�'
STA E OF FLORIDA
COUNTY OF � �, -
COUNTY OF ffV
Sto (or affirmed) and subscribed before me of
wor
Notarization
Swo to (or affirmed) and subscribed before me of
Physical Presen Online Notarization
Physical Presence or Online
e or
this'�2- day of St'7 - 20�0by
this�� day of , `� 20 by
1 1 i (3A Vf 0_4A
Name of person making statement.
Name of person making statement.
Personally Known 4 QR Produced Identification
Personalty Known V_11�" OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
F voliz
(Signature of Notary Pu 'c- State of Florida
{� �� gpRY Tracy A.Volz
Commission No. + � �'� o Nd �'ubIic
Notary Public
Commission No. state(rsatfEF �(ida
qState of Florida
!�� °tiCE}�� Comte# HH001i37
s
a
�� Ex fres 5118/2D24
REVIEWS
FRONT
F2U�Nll�ires
l/iRIiSOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA. AVENUE
FORT PIERCE, FL 34482-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
(Parcel Id#/Legal description/Address) l
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number , I acknowledge
that as owner of the above described property, and in accordance with Section
7.04.01(D), St. Lucie County Land Development Code, I shall be responsible for assuring
adequate drainage so that the immediate community WILL NOT be adversely affected.
I further acknowledge that in granting this permit for the development of this property,
St. Lucie County is neither obliged nor liable to provide for, or maintain in any form,
adequate drainage off my property which will not adversely affect the immediate
community.
*0erme (Please Print)gnature Date
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED BEFORE ME THIS aD- DAY OF '20
BY WHO IS PERSONALLY KNOWN TO ME (�} OR WHO HAS
PRODUCED
SIGNAT NOTARY PUB C
l f COMMIS NUMBER
SLCPDSD Revised 04/11/2011
AS IDENTIFICATION.
TYPE PRI�NTARY
Tracy A. Valz
tNotary'*AliC
-State of Florida
= Comm# HN001137
E 0� Expires 5/18/2024
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
Survey Requirements
The Board of County Commissioner approved a code change that will require a copy of a current sealed
survey when applying for a building permit for a primary structure or a building permit for an accessory
structure with a value exceeding $10,000. This became effective July 1, 1993.
The guidelines are as follows:
No Building Permit shall be issued for development unless a copy of a survey of the property on which
the required activity is to be permitted accompanies the application for building permit. All surveys shall
demonstrate compliance with the Filled Lands Affidavit signed by the Property Owners (refer to St. Lucie
County Land Development Code, Section 7.04.01.13.3.) and completely depict the following:
1. The location of the proposed development activity.
2. The relationship of the activity under application to all adjacent property lines, and as may be
required for the review of the application, all adjacent structures, improvements or natural
features, including but not limited to the nearest building corners of all adjacent primary and
accessory structures, pools and screened enclosures, fences, sheds, utility easements, wells, septic
systems, driveways, culverts and any landscaping or existing vegetation located along the
property lines.
3. A minimum of two (2) elevations along each roadway on which the proposed activity borders, the
existing ground elevation at the approximate center of the proposed structure, the existing ground
elevation along the side property lines adjacent to the proposed structure, and the proposed
finished floor elevation of the structure under application and finished grades for any adjacent
structures noted above in item 2. The proposed finished floor elevations must be consistent with
the approved Health Department On -Site Sewage Disposal System Construction Permit if on-site
sewage disposal is proposed.
All surveys submitted shall be prepared, signed and sealed by a Florida Registered Land Surveyor, in
accordance with the provisions of Chapter 61G17-6, FAC, except those applications for interior
modifications or construction, roofing permits not involving any structural alteration or additions to the
area covered by the roof surface, or any other permit required activity that. does not result in the expansion
of any portion of the existing structures shall not be required to submit a survey. Accessory structures
with a building value of less than ten thousand dollars ($10,000) shall not be required to submit a survey,
but shall instead be required to submit a scaled plot plan indicating the location of the accessory structure
and its compliance with minimum setback standards. Copies of original surveys meeting the above
requirements may be submitted with any application for building permit, provided that the survey still
depicts the accurate location of all structures and other improvements on the property.
Per Florida Administrative Code Chapter 61G17-6.006, paragraph 8, additions or deletions to
survey drawings by other than the signing party or parties is prohibited without written consent of
the signing party or parties.
SLCPDSD Rev 06/18/2010
2/9/06 cmf