HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �� Permit Number: ..'.,
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BUilding Permit Application PerSt.1_ucie 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: n� -�-�
PROPOSED•IMPROVEMENT.LOCATION,'-:" '
Address
PropertyTaxlD#: �J� �— W l 3- �3�1 Lot No.�
Site Plan Name: II Block No.
Project Name: �la
DETAILED.DESCRIPTION OF WORK:
A� 'r O - L� i 6 Le FT 0 t� v c i s as e�
V'O10 ' 7
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 _Shutters _Windows/Doors _Pond
Electric _Plumbing /� _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: / lD y Sq. Ft. of First Floor:
Cost of Construction:$ c2' 6 49• 00 Utilities: _Sewer _Septic Building Height:
V,OWNER/LESSEE:,,,-CONTRACTOR;',
Name Name: ' �VVl4
Addres . � ��611L�� c.( I z Company: f y��tv V xig4CLt C(AC22to
City: 0 1 b En-ce State: ( Address: gm—,
Zip Code: 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 r'S � [ C
from the Owner listed above) State or County License BhOl
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 TITLEHOLDER: _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 jobsite before the first inspection. If you intend to obtain financing, consult
with lfqder or an attorneyVefore commencing work or reco our Njotif,eQf Cqfnm4cement.
(ignatqLTi I of O e e Co c or as Agent for Owner Signatu of Cont actor tc er
S TE OF FLORIDA E OF FLORIDA
COUNTY OF COUNTY OF
Swor o(or affirmed)and subscribed before me of Swor o(or affirmed)and subscribed before me of
Physical Presence or Online Notarization Physical Presence or Online Notarization
this day of Yrvul 2JY by this day of 6- 1 202e'by
Name of person making st tement. Name of person making statement.
Personally Known / OR Produced Identification Personally Known / OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of REY (Signature of Notary lic-State of Florida)
rF
; AUDREY B.HU G �Q817
Commission N __ J4jyCOMMISSIU 23 Commission No.� = E RE Male ' 0;..•.. ., DREYB. EY
Fes° Bonded Thru Notary Public Underwriters :�: :,; MY COMMISSI0N#GG 3W817
March
6,2023
REVIEWS FRONT ZONING SUPERVISOR PLANS VE I'c OVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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