HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
0
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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) 452-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: ;"2 f Uti - t
Property Tax ID 9: Lot No.
Site Plan Name: ` Y' Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter
LCONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
—Mechanical _Gas Tank T Gas Piping _Shutters _Windows/Doors _ Pond
Electric — Plumbing _Sprinklers —Generator _Roof Pitch
Total Sq. Ft of Construction:_ "Y' ; Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name c \`' 1Nc' �" 1 i Name:__.�j_!�', '
Addre `1� Com an 5, �L �- r C.
p y
City: t State: Address: :.'
Zip Code: �L "L� Fax: City: -2 '_ _ State:V
Phone No. Zip Code: 7 Fax:.
E-Mail: Phone No J "' _Z f 7
Fill in fee simple Title Holder on next page [if different E-Mail t't± 03 0 qL-LAt '
from the Owner listed above) State or C unty License 'z Z.
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.
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 a d posted on the jobsite before the first inspection. f you intend to obtain financing, consult
with lender or'A attornev before commencing work or recording ur Notice of Commencement.
Signature 9f O essee/Contractor as Agent for Owner Signatur` o ntra ctor/License Holder
M ,
STATE OF FLO A STATE OF FLORIDA
COUNTY OF L" ��l _,_,.,. COUNTY OF
Sy rn to(or affirmed) and subscribed before me of Swo�to(or affirmed)and subscribed before me of
�`// Physical Presence or Online Notarization V Physical Pres a or Online Notarization
thi 8t5t�t day of"3,A 2025 by this 371-4day of 2024 by
-r
Name of person making statement. Name of person making st�at ent.
Personally Known i, OR Produced Identification Personally Known - OR Produced Identification
Type of Identification Type of Identification
Pro aced oduced
LIJ, J
(Signature of Notary Public igna ure of No ar Publi 511
z�R.p ANGELHAMILTDN � 6
Notary Public State of Florida
Commission No. *_: c*= I `�uIMl53iDN#GG9455
f,';r;5?n3�4:0 IRE:S:May 9,2024 mmission N ,�, � �?RisseioA G51478(}7
Bonded Thnr Notary Public Underwrite '? Rd` Expires 10f0212021
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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