HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /���� _
Date: Permit Number: ( V OL� -0-20
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Building Permit Application
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: C
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PropertyTax ID #: ( '" (1C>I 11�® S Lot No. / 7
Site Plan Name:Block No.`s
Project Name: na --s
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New Electrical Meter Second Electrical Meter
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Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank —Gas Piping Shutters _ Windows/Doors _ Pond
_ Electric _ Plumbing / _ Sprinklers _ Generator _ Roof Pitch
T�taly5;q Ft -of Co'nstr"uc ion?'s qJ(� Sq. Ft. of First Floor: _
�_ost-calf �Co�nstructryon , ' :_ ,; " Utilities: _ Sewer _ Septic
Building Height:
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Name:
)Address:
Company:
Address:
City:
Zip Code:5Lw\q ( h Fax:
City: State:
P,hione N oa
Zip Code: Fax:
Phone No
it in fee simple Title Holder on next page ( if different
E-Mail
State or County License
im the Owner listed above)
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.
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DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
State: City: State:
City: Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: — Not Applicable BONDING COMPANY: _,Not Applicable
Name: Name:
Address: Address:
City: City:
Zip:
Phone: Zip: Phone:
•
; . e..,'++., 1 rhP wnrk and instalfation as indicated.
OWNER/ CONTRACTOR AFFIUVI I : Application is nereuy•niduc r�• - -- -
1 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 Pespects, 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 our Notice of Commencement.
C
ssee/Contra Ir as Agent �fOr Signature of Contractor/License Holder
STATE OF FLORID STATE OF FLORIDA
COUNTY OF �. ;A_ COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of 2020 by
Name of person making statement.
Personally Known OR Produced Identification
T p of Identification
od .ed
Signa re of Not - ubli tate of Florida I
k i YNir LASHAH;4 A I.'.' �%V'RAHMING
Commission No. '��" Y°2i'5t;00 *� Mri�C01 i[A13S ,(3
°fir 40` EXPIRES: 06'A i► st 20, 2(192
E • i r.:
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
DATE
7
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of 12020 by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
PLANS VREVIEWON I SEATUITREV EWLE MREVIEWVE
REVIEW I