HomeMy WebLinkAboutBuilding PermitAIIAPPLICABLE INFO MUST BE COMPLETED FOR APPTICATION TO BE ACCEPTED
Date: *7-3O"J\Permit Number:
Plonning ond Development Services
Building ond Code Regulotion Division
2300 Virginio Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax; (7721 462-1578
Building Permit Application
Commercial
PERMIT APPLICATION FOR:
PROPOSED I M PROVEM ENT LOCATION :
Address: tA S Grr:,*rAo- i r..ne
Residentia I Y
Property Tax lD #:
Site Plan Name:
Lot No.
Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION I N FORMATION :
Additional work to be performed under this permit - check all that apply:
Total Sq. Ft of Construction:
Cost of Construction: $
_ Shutters _ Windows/Doors
_ Generator
Sq. Ft. of First Floor:
_ Roof _ Pitch
Utilities: _ Sewer _ Septic Building Height:
$/echanical
_ Electric
_ Gas Tank
_ Plumbing
_ Gas Piping
_ Sprinklers
lf value of construction is 25OO or more, a RECORDED Notice of Commencement is required.
lf value of HAVC is S7,500 or more, a RECORDED Notice of Commencement is required.
ZipCode: 3r{'if1 rax:
Phone No. V t) - tSa-?ff- s-
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name {Z hisl€-'T'h,-',.L
Address: i7 S nro..nr:r& Lc,.ne
city: PSL J State:ft,-
City: 'T?5 r'-
?27 t sL't
E-Mail Caaebc llcool; *< And L-e
State or County t-icense C a c- l( 3(5 ff3(
Ltteurr
Zip Code: 5'l'"1 S -5 Fax:
)1'cn*
SUPPLEMENTAL CONSTRUCTION LlEN LAW INFORMATION:
DESIGNER/ENGINEER: _PrVot Appticabte
Name:
Add
City
zip:
ress:
State:
Phone
MORTGAGECOMPANY: $trtotApplicable
Name:
Address:
City:State:
zip:Phone:
FEE SIMPIE TTTLE HOLDER: 12 Not Applicable
Name:
Address:
City:
zip:Phone:
BONDING COMPANY: Qwot Applicable
Name:
Address:
City:
zip:
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 Countv makes no reoresentation that is srantins a oermit will authorize the oermit holder to build the subiect structure
which is in conflict with anv a'policable Home Owters Association rules. bvlaws or and covenants that mav restrict rir prohibit such
structure. Please consult w'ith liour Home Owners Association and review'your deed for any restrictions raihich may a[ply.
ln 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 lojnty and posted o1 the jobsite before the first inspection. lf you intend -to obtain financing, consult
br an bttorn {befoie commencins work or rei:ordins vour Notice of Commencement.
'actor as Agent for Owner
subscribed before me ofu/ ,zofnlby
Type of
(sie of Notary
ldentification
pugti&al)
VEGETATION
REVIEW
DATE
COMPLETED