HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
ate: Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462--1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address:
Pro ertTax ID #: �1 (' 1-1 u
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
1
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Residential
Lot No.
Block No.
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:
Cast`ci f t+ nstruction: $ dl ti[)(� • 00
Sq. Ft. of First Floor:
Utilities: Sewer Septic
Building Height:
OWNER/LESSEE:
6NTRAC' OR
1\1arne. VOf L
=Names.
Address: •-
Compan
Compan
city: V. Q�C State: i. a
zip'Code: �-[ Fax:
PlYpne �1o:
Address. 5
Stater
� p
Zip Cod�)e: Fax:
Phone N �lia, l
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail 1
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: Not Applicable
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY:
Name:
Name: Address:
Address: City: State:
Y�
Cit State: Y
Zip: �-Phone:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY:
Not Applicable
Name: Address:
Address: City:
City: Phone:
Zip:
Phone: Zip:
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.
it
er
d th
St. Lucie County makes no repre�Homhe OwnerstAssgoc+at one rules, bylaw
or and couthorize the venants that may restrict borr proh structure t such
which is in con e c with any applicable
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the ranrthe Florida Bolding Codes and 5t. Lucie Coulnityit, I do hereby agree that I Amendments�e�orm the work
in accordance with theapproved plans
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
f commencement may result in
WARNING TO OWNER: YourfailuretRecord tide of tics o Commencement must be recorded paying he f o
public of St.
improvements to your property.
op Y A ain financing,
Lucie County and posted on the jobsit nbeno the orst irecco ding if you intend to obt Notice of Commencement.
consult
with lender or an attorne befor �� 1-1 / 0
ner/ Lessee/Contractor as Agent for Owner
TrATE OF FLORIDA
COUNTY OF ST
to (or affirmed) and subscribed before me of
Swo
Physical Presence or Online Notarization
this 5 day of CC Lae(- 2020 by
Name of person making/statement.
Personally Known ✓ OR Produced Ide ,`;`��,
Type of Identification �� ��..•*+•.,spy
.,
Produced fGg�
(Signature of Notary Public- State of
Commission No.
REVIEWS FRONTtREVIEW
COLiNTE
DATE
RECEIVED
DATE
COMPLETED
/License
STATE' OF FLORI A ,p•
COUNTY OF��_ b�
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this _day of G�'L�R.e� 2020 by
Name of person making statement.
Personally Known Z OR Produced Identification
,#llily
Type of Identification �'0�
Produced�•,.��•��RY
.•Om'.
ta�iignature of Notary Public- State of Florid} r
#l04i 2�83! � � RR3G;
d commission No. y.
' Nlic t1�
SUPERVISOR PLANS VEGETATION SEA TURTLE
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