HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Date
C"UL
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 349$2
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT
Commercial Residential
3 leSr/
Arlrlracc
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
Total 5q. Ft of Construction:
Cost of Construction: $
v�
OWNER/LESSEE.
(Affidavit required)
Generator
Sq. Ft. of First Floor:
Windows/Doors
Roof
Utilities: _Sewer Sewer _Septic Building Height:
Name &44�/L'a'
Address: 7���1 0,o3
4� State: �G
City:
Zip Code:-3 i i I Fax:
Phone No.
E-Mail: Lo
Fill in fee simple Title er on next page ( if different
from the Owner listed above)
CQNTRACTOR:
Pond
Pitch
Name: /C/ A,
Corn pa ny: if h Lc�Of
Address �l�¢�
City State: 1` G
Zip Code:��p Fax�fi�! ��t ou
Phone NdS6U (a f 7 _20
E-Mail O�- Gil
State or Couri License
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.
Name:_
Address:
City:
Tip:
Phone:
Name:_
Address:
City:
Zip:
Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work anct installation as inaicareo.
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 �fo-e-the-first inspection. If you intend to obtain financing, consult
with lender or an attorney b4 � e-cwiirencing work or recording your Notice of Commencement.
5ignature,of Own Lessee/Contractor as Agent for Owner
STATE OF FLORIPA
COLFNTY OFCf.&2439i f L --
Physical Presence or
Swc-n to (or affirm ) and subscribed before me of
this day of 2fa�� by
Name of person making statement.
Personally K��n OR Produtged identification
TvnasnFiry tsfiratinnPrnducPtf�-�LJ 1 f fC .is
natu of I o ry Pufilic- State of FI ida
DAISY PERRY
Commission No. (Seal) *. k_ MY COMMISSION 4 HH 102541
P EXPIRES: June 27, 2025
•';;ORFLQ.` Bonded Thru Notary Public Undervwilers
Online Notarization
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION -
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 5/20/21