HomeMy WebLinkAboutbuilding permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
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Plann.0
ing and Development Services
ti
Building and Code Regina on Division
Building Permit Application
2300 Virgin10
ia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial Residential
PERMIT APPLICATION FOR: ELECT(z I C)\ L
PROPOSED IMPROVEMENT LOCATION.,
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Address: BEN 6 �4
Property Tax ID #:
Site Plan Name:
'**On MPAD
Lot No,.
Project Name:
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New Electrical Meter
Additional work t
Mechanical
Block No.
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Second Electrical Meter
o be performed unde
Gas Tank
GONNOWNW00
r this perm'i't —
. Gas Pipin,
check all that apply:
T Shutters Windows/Doors Pond
_Electric _ Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ a .��J.$� __ Utilities: Sewer Septic BuildingHeight.
OWNER/LESSEE:
Address.
City:
Zip Code:
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Awl'
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Fill in fee simple Title Holde
from the Owner listed aboi
i a affimm-
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Name.,
�Xl .
State:��
on next page (if different
C o m p a n y: CcL\ V Yd"\WDi C
Address: i01C) 1�.� i U��a.�l
City: F-� . Qi�C�- State: F� .
Zip Code: `3`-15 � Fax: Rio J
Phone No
Ea-Maill.
State or
County License
if value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
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if value of HAVC is $7,SOO or more, a RECORDED Notice of Commencement is required.
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IMP
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: 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: 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.
n consideration of the granting of this requested permit, I do hereby agree
n accordance with the approved plans, the Florida Building Codes and St.
The following building perm
it
0
applications are exempt from undergoing a 0
accesso
structures , swimming pools, Tences, wails , signs , screen
WARNING TO OWNER: Your failure to Record a Notice o
improvements to you.
r
f
that I will, in all respects, perform the work
icie County Amendments.
eco rdingN*I-1 111111k'\ JQN'W' - �' f%%l, WN
NN U2
r property. A Notice of Commencement must be recorded in the public records ot St.
Lucie County and posted on the ioi41
bste before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commenc'ini
full concurrency review: room additions.,
ooms and accessary uses to another non-residential use
Commencement may result in paying twice for
ry
work or r
your Notice of Commencement.
3
Signature 6o'k-wner/ Lessee/Contractor as Agent for Owner Signaturkof Contractor/License Holder
STATE OF FLORIDA
COUNTY OF � . �--L�C\l
_
Swor o (or affirmed) and
P ysical Presence or
this 1 day of1
subscribed before me of
Onli
Name of person making statement.
ne Notarization
2024 by
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- Sta
Commission No.
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
ev.Tb726—
FRONT
COUNTER
s
STATE OF FLORIDA
COUNTY OF � 1--UC•1
Sworryto (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this, �l day of. � tLe) , 2024 by
Name of person making statement.
Personally Known �OR Produced Identification
Type of Identification
Produced
i aturdjf Notary Public - State
�i* • Notary Public State of Flori a (�
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06/0512022' EKpires
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06/05/2022
VEGETATION
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Notary Public State of FI ri <
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+5 Commission GG 21
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SEA TURTLE
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