HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
9UG WULE
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: 1
Address: ��VIA'
Property Tax ID #: 51:[q1^-_` 5o
Site Plan Name: �u Y'l6l.. Q
Project Name:
DETAILED DESCRIPTION OF WORK:
r1►.�.i i
FAR
r r%IAP
Lot No.
Block No. 36
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 r Generator Roof Pitch
Total Sq. Ft of Construction:_ � Sq. Ft. of First Floor: __--
Cost of Construction: ik 15j c Utilities: —Sewer —Septic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name 'u.V C- & it ar�hc�
Name:
Addr s: .. F- Pafflcl YL4LCUBVdCompany:
City: - luac, State. _
Add-C:�L S,
0
CityCW-1
Stater
Zip Code: Xq 15G- Fax:
Phone No.-(-`7--eD2 0&
Zip Code: �54q52.
Phone No 7+rz Lo- I°
Fax:
(Q aLa 6
E-Mail:
Fell in fee simple Title Holder on next page ( if different
E-Mail Dai u
Li V)
State or County License roc
Z�
from the Owner listed above)
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 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 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 Jgncler or an attorney before commencing work or recording our Notice of Commencement.
Sign ure of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA j '
STATE OF FLORIDA, r
COUNTY OF �i /
La -le
COUNTY OF 54"n i
Sworn or affirmed) and subscribed before me of
Sworn r affirmed) and subscribed before me of
hysical Prese a or Online Notarization
�i
hysical Pres a or Online Notarization
this4 ay of tI�— 2024 by
thisr'dayof 202$ by
�.n 3-A-n
Name of person making statement.
Aame of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Typ dentification
Typ {fication
Produce
4mo PA ��
Produced
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(Signature 6f Not
blic- State of Florida)
(Signature of Notary P4 bli State of Florida)
Commission No.
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Commission No. (Seal)
NotsrY PU0, $1ow of Florida
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$Leto d Florida
REVIEWS
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PLANS
Pamela J
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MANGROVE
REVIEW
REVIEW .
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DATE
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Rev. 2