HomeMy WebLinkAboutBuilding Permit Application All APPLICAB E I O MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: � , �O
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE:
Property Tax ID#: jq� ; t9SgV ,3 OO Lot No.�
Site Plan Name: Block No.
Project Name:
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Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters -Windows/Doors
_Electric _Plumbing _Sprinklers _Generator ;Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ ' '''` Utilities: —Sewer _Septic Building Height:ws�,., ��Pxs ��;a �s.e_aw.,.-,...__.,,���..,
Name �^ h Name:
Address: b CornPany:
City: State: ;,, ,Address:
Zip Code: C Fax: City: State:
Phone No. Zip Code: Fax:
E-Mail: Phone No-
Fill in fee simple Title Holder on next page( if different E-Mail
from the Owner listed above) State or County License
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC 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:
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 YOUR PAYING
TWICE FOR PROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
PO TED HE JOB SI Y" BEFORE THE F!RST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
W H YOUR/LENDER R N ATTORNEY BEFORE RECOIRDi G YdLIQ NOTICE OF COMMENCEMENT."
g ature of Own ssee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF $k,L%sc,ie COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this_%_day of ,2*N by this day of 20_ by
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Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personal ly''K��nw i) OR Produced Identification
Type of Identification Type of Idenk•t,ification
Produced Produced
(Signature of Notary lic-State of Florida ) (Signature of Notary Public-State of Florida )
Commission No. (Sea19EANNAGIVENS (Seal)
,�� ��e,. p Commission No.
Notary ublic•State of Fiori a
6159
Commission s a
jan28,2025
through National Notary
REVIEWS FRONT ZO O PLANS VEGETATION SEATURTLE MANGROVE
COUNTER W REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19