HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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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:
PROPOSED IMPROVEMENT LOCATION:
Address: 11 WAVS, 1316d
Property Tax ID#: 'q502-;- 5ot -N 9� - oco - Lot No,
Site Plan Name:- -::3C—)n�-0-r V-e- m'ac Block No.
Project Name:
DETAILEn DESCRIPTION OF WORK: ��y--
New Electrical Meter Second Electrical Meter—
[CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical ,Gas Tank —Gas Piping ShuttGr& Window-.Doors Pond
—Electric —Plumbing —Sprinklers —Generator Al�'�oof 44 Pitch
Total Sq. Ft of Construction: + Sq. Ft. of First Floor:
Cost of Construction:$ Utilities: —Sewer _Septic Building Height:
OWNERAESSEE: ' CONTRACTOR:
Name"/)ft= ( ICI t Name:
Address:8539 Company:
'Pin U-06
City:&Wr) (IMAL State;
Wi Acldr s):
Zip Code: Fax:
State:kJt
Zip Code: Fax:
Phone No. bqu, - 15cfy
E-Mail: Phone No —+T-1 (02 (0 2- 0 A
Fill in fee simple Title Holder on next page if different E-Mail
from the Owner listed above) State or Cgunty 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.
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.
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 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 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 in the public records of St.
Lucie County and posted on the)obsite before the first inspection.If you intend to obtain financing, consult
with lender or an attornev before commencing work or recording our Notice of Commencement.
ture of Ow /Lessee/Contractor as Aj(enVfor owner Si Lure of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY c �k COUNTY OF
Sw to(or affirmed)and subscribed before me of Swor o(or affirmed)and subscribed before me of
Physical Pres a or . Online Notarization Ph at Prese or Online Notarization
thist ay of 02ib by thi of 2024 by
Name of person making statement. U / Name of person making state
Personally Known OR Produced Identification!/ P na own OR Produced Identification
Type 9o_f1dP ificatio Type of ldenti catio
Prod ced l-- Produced
(Signature of Notary Pu o o+a�v stm of Fwwa (Signature of Notary Publi S f Fib Dubuc state of Florida
Pamela Jones Pamela Jones
Commission My on GG 9854 IF 5/2 2 i185470
70 Commission No. Mr
s�2024
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Expires 06 1512024 a
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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