HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE. COMPL FOR APPLICATION TO. BE ACCEPTED
Date: `� �, Permit, NumberU /9 0�
SEP 15 2023
Building Permit Applicatio T. Lucie County, Permitting
Planning and Development Services
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:
Address:
W
Property Tax ID #: T % �� �y (� -�)_ 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 _ Windows/Doors Pond
— Electric _ Plumbing _ Sprrirn�klers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: z ' g^ Sq. Ft. of First Floor:
�---
.Lost .ofConstruction: $ 52C-.O Utilities: _Sewer _Septic
Name_ 't5u J }t AJrQAJ Name:.
Addres7 <�� Company:
City: State: _f Address_ :
Zip Code: 3n22 Fax: City:
Phone No.__ ��o) ��� �j4 Zip Code:
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 Licer
,Building Height:,
Fax:
State:
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.,
OWNER/.CONTRPICTOR AFFIDVIT: Application is hereby made to obtain. aipe.rmitto do the work and. installation as indicated.
I'cerfifythat,no work or installation has commenced priorto the.issuance,of a permitp ;
St. Lucie County. makes no representation that is' granting a permit will abt aws eor and co a ant-that.may estr ctbor:pr hib t such
which is in conflict with any applicable Home Owners Association rules, y . ,
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 l 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, swimmingpools, fences, walls, signs, screen, rooms and accessory uses to another non-residential use
'WARNING TWNER: Your failure,to Record. a'Noticeuof.Commencement may result in paying.tvwice for
improvements to your property. A-Notice_of Commencement must be recorded in`the,public'recogr c of St.;
Lucie County, and ;posted on the `jobsite before the first inspection. If" -you intend to obtain: f nancin ,consult
with lender or;an attorne before commencing work or recording our Notice of �Commerfcement.
Signature of Owner/ Lessee/Contractor as gent- or Owner
STATE.,OFTLORIDA
COUNTY'OF '
Swop to (or affirmed) and subscribed before me of
Phy ical Prese¢Cdo�rOn�ine Notarization
this�'� T&y of � 20. by
Name of person making statement:
Personally Known OR.Produced Identification
Type of Iden i t' n .-
(Signature of Nota ku BEY .�UMPHREY v
; MY COMM S 4 # C0 300817
Commission'No. _ : EXPiR ch612023
PuGjlc UndelvL
7i4i,-Bonded?hru•Nctaryl.� $+
Signature 'of Contractor/License! Holder .
STATE OF FLORIDA'
�COUNTY,OFn
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of , 20 by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification ;
Produced
(Signature of Notary Public- State of Florida.)
Commission No. (Seal)
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DATE •
COMPLETED
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