HomeMy WebLinkAboutBuilding Permit Application All APPLICAB E INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date : � � � Permit Number :
_TC IL
Building Permit Appli ation
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 : � E CT El
PROPOSED ... . ..... . ..
ITT
IMPR -- --- -
OVEMENT IOCATIO NM.
.. . ......... . .. ....
Address : n� UI � � �^OP�C1�• �`� ��. .� '�('C�'
P rope rty Tax ID # : � WPM Lot N o .
Site Plan Name : �rDTiC.� l �- �� Block No .
Project Name :
. DETAILED DESCRIPTION OF -WORK :
A.
New Electrical Meter Second Electrical Meter
--------- -
-—------------
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CONSTRUCTION INFORMATION : .
Additional work to be performed under this permit - check all that apply *.
Mechanical Gas Tank _ Gas Piping _ Shutters Windows/ Doors _ Pond
qmnvp�
E l ectri c _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq . Ft of Construction : Sq . Ft . of First Floor :
Cost of Construction : $ � Utilities *. _ Sewer _ Septic Building Height :
=w raw +� �. "�, . .` �
ESSEE .. ... -� �U _ � � CONTRACTOR :
Name .......
. .. . ....... N a m e : . �CS:�CY
Address :. don �^ ^ � � � � `� Company : �0. �. �
City : t'-t . ��CS>- States. �} Address : \ L Q
r
Zp CodiCode : F a x : city -9 � tCy— State :�"�
Phone No . � �' 49 Zip Code : � v� Fax : wool"�� t�
E - Mail : Phone No
Fill in fee simple Title Holder on next page ( 'if different E - Ma *11
from the Owner listed above) State or County License
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required .
If value of HAVC 'I's 7, 500 or more, a RECORDED Notice of Commencement is required .
SUPPLEMENT FORMATIOMy M
-
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DESIGNER/ ENGINEER : _ Not Applicable MORTGAGE COMPANY : _ Not Applicable
Name :9
Name :
Address : Address :
Ci ty : State : C i ty : State :
Zip : Phone Zipffi Phone :
FEE SIMPLE TITLE HOLDER : _ Not Applicable BONDING COMPANY : _ Not Applicable
Name : Name :
Address : Address :
Ci ty : City :
Zip : Phone : Zi p : Phone :
OWNER/ CONTRACTOR AFFIDVIT@, Application is hereby made to obtain a permit to do the work and installation as indicated .
1 certify that no work or installation has commenced pr ior 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 con lict 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 i' n the public records of St .
Lucie County and posted on the Jobs 'ite before the feirstinspect 'ion . If you intend to obtain financing , consult
with lender or an attorney before commencing work or record *iniz vour Notice of Commencement .
Signatures f Owner/ Lessee/Contractor as Agent for Owner Sign t re of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF
Sworn or affirmed ) and subscribed before me of Swor o or affirmed ) and subscribed before me of
Physical Presence or Online Notarization Physical Presence or Online Notarization
th is �' day of 2024 by this day of 2024 by
.-.P P P
Name o person making state nt ,. Name of person making state nt.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced P rod uced
C U _Q
( SignatuM of Notary Public iillll III ignature o Notary Public- State of'
OP P'y* Notary Public State of Florida
C1 :° � rat E Montepare �� �9i Notary Public State of FI, ida
Commission NO. a�� �1 � � � (pmmission GG 214990 mmission NoC�n1,� ���'Q � a I Margaret E Montep r
•�j ,� Expires 06/05/2022
`a� �- ,p my Commission GG 2 4 0
a � Expires 06105/2022
REVI EWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVI EW
DATE
RECEIVED
DATE
COMPLETED
ev . 5/ 6/ 20