HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE I FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date : � Permit Number :
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Building Permit APPIication
Planning and Development Services Building and Code Regulation Division Commercial ResidentialV/0
2300 Virginia Avenue, Fort Pierce FL 34982
Phone -ff. ( 772 ) 462- 1553 Fax : ( 772 ) 462 - 1578
PERMIT APPLICATION FOR : E L Tj
POSEDIMPROVE M - LOCA ION . _ , . Id
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Address : , 302, — �i4�P1CJ�1 L . SLES IJr?CLE FTS �i �nc � �1g8 �
Property Tax ID # : � d —Jr(JC) lS7- C�C� — l got No .
Site Plan Name : Block No .
Project Name :
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DETl� IL` E D DESCRIPTION _OF WORK : wvvA
fir
Fl �t�f�l lam,
New Electrical Meter Second Electrical Meter
LCONCTION ` IN FOR M AT fO N`-�`
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Additional work to be performed under this permit — check all that apply :
Mechanical Gas Tank _ Gas Piping _ Shutters W 'I' ndows/ Doors _ Pond
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq . Ft of Construction : Sq . Ft . of First Floor :
Cost of Construction : $ c5 � U ti li ti e s : _ S e w e r _ Septic Building Heights.
W ER/ LE55EE : . CONTRACTORL 21 . L_ I
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Name Name : Q�
Address : - ?io1Ll -' �� ico,. ZS � �S I �G � Company : �. � CCU.
city : PCs, State : � Add ress : Olv �n] Mlc�
Zip Code : 3� Q � oZ Fax : C ity : � .�iC'rC... 2� State : ,
Phone No . ,1111111111111111111111111 gam — 4 g � �� �4� Zi p Code : c — Fa x :
E -wMall . Phone No - ag
Fill in fee S 'lmple Title Holder on next page ( if different E - Mail -
from the Owner listed above ) State or County License E C 1 �cNc� 11n
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 i's required .
IX
VSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION"
DESIGNER/ ENGINEER : � Not Applicable MORTGAGE COMPANY : _ Not Applicable
Name : N a m e :
Address : Address :
Ci ty : State . City : State :
Zip -* Phone Zip : Phone :
FEE SIMPLE TITLE HOLDER : _ Not Applicable BONDING COMPANY : _ Not Applicable
Name : Name :
Address : Address :
C ity : City :
Zi p : Phone : Zip : Phone :
OWNER/ CONTRACTOR AFFIDVIT :, Application is hereby made to obtain a permit to do the work and installation as indicated .
I 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 p ermit will authorize the permit holder to build the subject structure
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which is in con lict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
1
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 ma y result in paying twice for
i16
mprovements 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 co enci' n work or recordi' ng our Notice of Commencement .
Signature of O er/ Lessee/Contractor as Agent for Owner Signat of Contra ctor/Lice nse Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF . COUNTY OF
Swo to or affirmed ) and subscribed before me of Swor o ( or affirmed ) and subscribed before me of
Physical Presence or Online Notarization Physical Pres nce or, Online Notarization
this � day of '���� , 2026 by this � day of � �rl �— , 2026 by
Name of person making stat ent . Name of person making stat e nt .
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
Signature0of Notary Public- State i re of Notary Publilcm St
--1 . Ay wi Notary Publie State of lorida Notary Public State of Florid
iP �`� ��f^ ret E montepare
Commission No . ClE5alLlc 19U e% 1 ) Margaret E Montep room Sion No . � � � � y� mmission GG 214990
My Commission GG 21 990 �; �? Expires d� Expires 06�65/2022 or a 06105J2022
REVI EWS FRONT ZONING SU PERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVI EW REVI EW REVIEW REVI EW REVI EW
DATE
RECEIVED
DATE
COMPLETED
ev . 5/ 6/ 20