HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ';L I Q l + 31 q I
Date: Z_ Permit Number:
�'a [LUC
Building Permit Application
JAN 11 1021
Permitting Department
St. Lucie Count".'
Planning and Development Services
Commercial Residential
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
V
Address: 1
Lot No.
Property Tax I D #:
Block Na.
Site Plan Name:
Project Name:
New Electrical Meter Second Electrical Meter
Additional workto be performed under this permit —check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers — Generator
Total Sq. Ft of Construction:
Cost of Construction: $
Sq. Ft. of First Floor:
Windows/Doors — Pond
Roof Pitch
Utilities: Sewer Septic Building Height:
Name
Address: 7Y423 d 'e'J'
City: 49 l�r� State: R,
Zip Code: 3 Fax::
Phone No.
E-Mail: 00
Fill in fee simple Title Holder an next page { if different
from the Owner listed above)
Name:
Company:
Address:
cih
Zip Code:
Phone No
E-Mail
State or County Licen
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.
Fax:
State:
Vex I
R Lai L
DESIGNER/ENGINEER: _ f Not Applicable
Name:
MORTGAGE COMPANY:
Name:
/Nat Applicable
Address:
Address:
City: State:
Zip: Phone
City-
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: -,/Not Applicable
Name:
BONDING COMPANY:
Name:
Not Applicable
Address:
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 TO OWNER: Your failure to Record a Notice of Commencement may result in paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or recording your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Molder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
Sworn to for affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physicai Pres nce or Online Notarization
Physical Presence or Online Notarization
this -LL day of 2020 by
this day of 2020 by
Name of per n making statement.
Name of person making statement.
Personally Known OR Produced Identification _ems_
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
{S€`gna re of NotqNublic- ate f
(Signature of Notary Public- State of Florida)
{n
KAREI J IVI�L�ENCommission No. -,of Fio.(3�p:ary Public
Commission No. (Seal)
Cp�7lS11iS51011 77Gv 207484Gov
Commission Expiras
un
REVIEWS
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ii
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.D.3_) and completely depict the following:
1, The location of the proposed development activity.
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 61 G 17-6, 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 S, 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 cml