HomeMy WebLinkAboutbuilding permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
C�
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginigo
a Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMI'T APPLICATION FOR:
PROPOSED' I
Address,.
Commercial
E CTF C/"\ L
MPROVEMENT LOCATION:
C,
PA
LL
Property Tax I D #:
S'I'te Plan Name.
Project
Name:
Residential. �
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CONSTRUCTION INFORMATION:
Additional work to be performed unde
Mechanical _Gas Tank
Electric
Total Sq. Ft of
Cost of Constr
Lot No.
Block No.
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r this permit —
_Gas Pi pi n
ir
check all that apply:
Shutters
Windows/Doors
Pond
Plu bing Sprinklers Generator
0
Construction: Sq. Ft. of First Floor.,
T Util*ities: Sewer Septic He'l'ght:
uction. i
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Name
Addresse..
C1uty
Zip Code:
Phone No.
�4� Name: ,��1eS � �C►-�U�C� ...� �,
Company: \ksm.S�c��
Fax:
State 9)c �.
E-Ma'11:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Address: lC1C7- l�
City:
Zip Code
hone No
?j� a- Fax
E-MailW-%- ��� x�'Z
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.
State:..,
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name0 : Name:
Address.- Address:
City: State: city -Do State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address,. Address:
City: City:
Zip: Phone:- Zip: Phone.
OWNER/ CONTRACTOR AFFIDVIT.1 Application is hereby made to obtain a permit to do the work and installation as indicated,.
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 t
in accordance w
ith t
The following building perm
acces
he granting of this requested permit, I do Hereby agree that I will, in all respects, perform the work
he approved plans, the Florida Building Codes and St, Lucie County Amendments.
applications are exempt from undergoing a full concurrency review: room additions,
it
sort' 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.
with lender or an attorne
Signa
Lucie County and posted on the Jobsite before the first inspection. If you int
before commencing work or recording your Not*i
ture Owner/
Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
Signatu
f Con
end to obtain financing
ce of Commencement.
dF
tractor/License Holde
r
STATE OF FLORIDA �.
A�, COUNTY OF
Sworn-lo (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this a day of
Name of person making statement.
2026 by
Personally Known Xo' OR Produced Identification
Type of Identification
Produced
ir
(Signature 9f. Notary Pu4
Commission No.
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
ev,,T6720
10
Notary Public State of Roricia
4p Mar montepare
� s
. my cbmrns ion GG 214990
y�os n� Expires o6i0512022
Swo t o (or affirmed) and subscribed before me of
Pysical Presence or Online Notarization
this c�Cc day of
2024 by
Name of person makingstat ent.
Personally Known � OR Produced Identification
Type of Identification
Produced
otary Public- 51
Commission No. GC;1n�
(Signature Q-
QF�
consult
e oT Fiori-aa
0y1�6 Nolary Public State of Florida
aet E Montepare
� almission GG 214,990
�y�� Expires 0610512022
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