HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Planning and Development Services Building Permit Application
Building and Code Regulation Division
2300Virginia Avenue,Fort pierce Fi34982 Commercial Residential
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: n,.�n
PROPOSED IMPROVE ENT LOC ION; C J r ! f 1
Address: OD
PropertyTax ID 1#: U J F Q� [� �a O
Site Plan Name: 1 Lot No.
Project Name: Block No.
OI TAILED DESCRIPTION OF WORK:
4
New Electrical Meter„ —Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to he 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:
5q. Ft. of First Floor:
Cost of Construction: $ I 7 7 Utilities: — Sewer _ Septic Building Height:
OWNER��ESS�E�!.���CONTRACTOR:
Address:C
City' rC IZip CodeFax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Compa
City: �%%� Stater
ZIP Code: Fax:
PhoneNo—','7 4j�j—
E-Mail 5 �te ey M k� ,
State or County License
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC Is $7,5W or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTALwl
LJEN LAW'
__ Not q—�` Ie—
name: Ppiicai�le
Address:
City:
Zip:------�— Phone State:
FEE SIMPLE TITLE MOLDER:
Name: �_ Not Applicable
Address:
City:
Zip: Phone.
OWNER/ NTRACTOR AFFIDVIT: Appli
l certify thcation is h b
at no w k
MORTGAGE CORAPAIII
Name: Not Applicable
Address:
City:
Zip: Phone: State;
BOND1111 CQMPANY:
Name: _..._Not Applicable
Address:
City:
Zip: Phone:
ere y made to obtain a permit to do the work and in
r ar+nstallation has commenced prior to the issuance of a permit. stallation as indicated.
St. Lucie County makes no representation that is granting a permit will authorize the ermit holder to build
which is in con ict with any applicable Home Owners
structure. please consult with your Home Owners Association and review your deed for any restrictions which m
Association rules bylaws or and covenants that may oar p structure
In consideration of the granting of this requestedy Prohibit such
in accordance with the approved plans, the Florida u Building codesandSt Lucie CountyAmin all endments.Amendments Perform the woay rk
ly.
The following building Permit applications are exempt from undergoing a full concurrency review: room
accessory structures, swimmin
WARNING'To g Pools, fences, walls, signs, screen rooms and accessoryom additions,
Q OWNER: Y failure to Record a f�otiee of Ccsmmencent� may �5e nattier non-residential use
improvement to your p operty. A Notice of Commencement rr a reca de in the Public Lurie Count a pasted n thelobsite before the first inspectio . if ou f end in the ubli fre
or
With! ender,or a a;-torne before cornmencin work ar recardln�r N rl, Q n� � �- ec records of 5t.
� 1 l ^� attain financing, consult
Signature
Agent for Owner
STATE OF 1_ RIDA �
COUNTY F �e .
STn to (%a rrmed) and subscribed before me of
I� p si i-Presen or Online Notarization
this day of
202q by
- � CkY
Name of person making statement.
Personally Known 2LOR produced identification
Type of identification
- a• • ... u,aor� Fublic- state of R
4��,�{ L MON
Commission No. �r `.y (�.tis5�D,y•
REVIEWS FRONT �
COUNTER RERI REV1 NOR
)ATE
iECEIVEi3 �����,a•: otary SQL
Signature
STATE
Sworn toVrIlaoll
irmed) and subscribed before me of '
sesence r Online Notarization
ths�
202f by
Name of person making statement.
Personally Known --.k__ OR produced !de ti cation Type of identification
Produced
{ ign ure Nota
:ommission Na. NotaryPubecSta*ItFkid,
a Kep M�
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VEGETATION SEA TURTLE I MANS G� l�
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