HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ~ �
Permit !Number:
LL CUL
Building Permit Application
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: t✓ d f lNr fTt+ PI e- c-
Property Tax ID #:�„lam[ Lot No.
Site Plan Name:
Project Name:
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
Block No.
Additional work to be performed under this permit —check all that apply:
Mechanical _ Gas Tank — Gas Piping _ Shutters _ Windows/Doors Pond
_, Electric — Plumbing `Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $
OWNER/LESSEE:
Generator ` Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic
City: e' I State:'��
Zip Code: Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Nam
Corn
Building Height:
-a Ct
City- State
Zip Code:M Fax:
Phone No
E-Mai
State or County Li se
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.
F
ENTAL CONSTRUCTION LIEN LAW INFORMATION:
ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name:
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 snakes 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 lender or an attorney before commencing work or recording your Notice of Commencement.
of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed hef�rg me of Physical Presence or Online Notarization
this IQ -- day of ' Z 20 ] by
Name of person making statement.
OR Produced Identification
-L22 ( ) G�-- -�'
( gnature of t lic- State of Florida }
Commission No. (Seal)
REVIEWS FRONT
COUNTER
DATE
RECEIVED
DATE
COMPLETED
ZONING
REVIEW
+ Waiery Pubad Stall of Fkmds
Kevin D Cook
AAy Commission GG 349484
Expires 061271=3
PLANS �
SUPERVISOR
I
REVIEW VEGETATION I S REVIEW MANGROVE