HomeMy WebLinkAboutApplication and drawingAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
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Planning and Development Services
Building and Code Regulation Division
Permit Number.
Building Permit Application
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial V
Residential
PERMIT APPLICATION FOR. C L E
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ROPOSED IMPROVEMENT LOCATION.
Ad d ress C)
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Lot No.
S'lote Plan N ev. Block No.
Project Nam
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Additional work t
Mechanical
o be performed
Gas
Tank
_ Electric _Plumbing
Total Sq. Ft of Construction:
Cost of Construction:
J
under this perm
Gas
_ Spr"i
it—
pin
nkle
check all that apply:
Shutters
rs 1 Generator
Sq. Ft. of First Floor:
Utilities: Sewer SE
Windows/Doors
Roof
tic Building Height:
Pond
Pitch
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OWNER L CONTRACTOR
L, .4 L+iYi __'7Y r,,;; •:'{-.
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-- ----- - - --- ........ - -- -- ------ -----
Name er jez,,%) Name: LA
•a{
Address.
City: ie
Zip Code:
Phone No..
E-Mail,.
Fill in fee simple Title Holder on next page if different
Cra
one ,N'iT C,
State: F�
Fax:
from the Owner listed above)
Companyo.1
Address: lam(
city: �
Zip Code,.
Phone No
E - M a i I
State or
C�mc,S cc�
Fax
dpEb
State:
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.
� 1
with lender or an attorney before co encein
Signature ofAwnerjLessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
Swor or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this.!J+h.day of MO.Yt% , 2026 by
Name of person making statement,.
Personally Known OR Produced Identification
Type of Identification
Produced.
(Signature of Notary Public- State of f�*
Commission No.,
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
e ve -'5/6/20
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY:0
Not Applicable
Name: Name:
Address: Address:
City: State: City: State,.
Zip: Phone Z'Ip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address,: Address:
City: City:
Zip: Phone. Zip: Phone:
TWNER/ 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 permitholder to build the subject structure
which is IP
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.
Inconsideration 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..
to 0
The following building permit applications are exempt from undergoing a full concurr
accessory structures,, swimming pools, fences, walls, signs, screen r
WARNING TO OWNER: Your failure to Record a Notice of
ency review: room additions,
oorns aria accessory uses to another non-residential use
Commencement may result i
n paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records ot!5t..
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
work or recording your Notice of Commencement.
Signa'
e 0?�eontractorlLicense Holder
STATE OF FLORIDA
COUNTY OF � • ��-��
Swornto (or affirmed) and
Ph�sical Presence or
this '-1+ day of � tAgii
subscribed before me of
Online Notarization
2021 by
James E. , MaLAA�
Name of person making statfiwfient.
Personally Known OR Produced Identification
Type of Identification
Produced-
MWMW of Notary Public- State o
.ram Notary Public State f Florida
Ga.l R(7b:� Margaret E Mont mis ' n No.
} . _ My Commissten GG.Ze
Expires 06105/2022
�✓t'� ►ty� Notary Public State of Fl ida
� Margaret E Montep r
My Comrmsslon GG 2 t 4 0
y?� ntl� Expires 06/05/2022
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
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