HomeMy WebLinkAboutBuilding Permit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
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
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
address: 5100t Fbvi- 9 t .� Vlt_ VI!
Residential
Property Tax ID #: 3 4 i Lot No.
Site Plan Name: Block No. „
Project Name:
DETAILED DESCRIPTION OF WORK:
IJ
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
_ Electric _ Plumbing , Sprinklers _ Generator
Total Sq. Ft of Construction: o 6 1 "1 Sq. Ft. of First Floor:
Windows/Doors Pond
_ZRoof Pitch
Cost of Construction: $ C '� 0 0 b-- Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name TAfoa A n Name: i
Address: SQZ. i Company:-ML3 Jlt Lf I/}}/j (l.{ �h
City:.Ft. ki'LC. State: FAddress: �� S
Zip Code: 4CACO I Fax: City: V Y4_ V��iAUk _ State: FL -
Phone No. -i jlKh Q Zip Code: '�IA'III Fax:
E-Mail: Phone No `~I . `[5
Fill in fee simple Title Holder on next page ( if different E-Mail 1(b a
from the Owner listed above] State or County License ft 0
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 CONSTRUCT N LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
Address:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: , Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
F%1A IR1 Cn/ PA w l-rnw/+rAe.
• Vv l.l_r.l \.V1.1 nrtiL 1 tin wrrOvi i : Application �s 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 Countyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in contiict 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 iobsite before the first ins ection If ou intend t bt ' f'
with lender or an attorne before commencing work
p . y o o ain Inancing, consult
or recording our Notice of Conwencement.
F ��
S, ure of O er/ Le ee/Con actor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF rt r
COUNTY OF� n, 2try�
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
i/ Physical Presence or Online Notarization
this qL day of 2024 by
✓Physical Presence or Online Notarization
this. day _Z+.�
,
of ,.� 2020 by
Name of person making statement.
;/OR
Name of person making staement.
Personally known Produced Identification
Personally Known ----OR Produced Identification
Type of Identi f '
Type of identlficat'
Produced
Produce
(Signa r otarr"
(Signa stir to Q4 Af*4�ameAbla rld
Leslie Brown
Commi I Commission 924796 (Se 1)
Leslie Brown
My Commission C3G 920768
Commi I r }}
4 ail
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
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REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20