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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MIDST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: Building PermitApplication Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax. (772) 462-15 78 PERMIT APPLICATION FOR: Address: Commercial Tax ID #. Property Site Plan Name: Project Name: r , New Electrical Meter Second Electrical Meter Residential Lot No. Block No. Additional work to be performed under this permit - check all that apply: d.� echanical Gas Tank Gas Piping Shutters Windows/Coors Pond — Electric �. Plumbing Sprinklers Total Sq. Ft of Construction: Cost of Construction: $ �.�. utiliti ;OWN'' Name ......_..r... .:, _ _� �. Address: V City: — �a _ a State: Zip bode: � -_ Fax, - Phone N o o I °. �--? -Mail, Fill in fee simple Title Molder on next if different page ( from the Owner listed above) Generator Roof Pitch Sq. Ft, of First Floor: If value of construction is 2SOA or more, a RECORDEDNotice of Commencement s $7,SOo ©r more a RECORDED is reqrequired.If value of MAVE i C)RpEp Notice of commencement is required. DESIGNER/ENGINEER: :L iv tf� IlV I I I� L) K .. Not �. r__ - ---.. �..r..�._..�..�.._._a._�....�.®...Y..... Applicable �MQRT(II c,ip CCQM PANY: Name: Address: City..State: Zi P: Phone FEE SIMPLE TITLE HOLDER: of Applicable Name. Address: City: Zip: Phone: Name:_ Address: of Apolicable City: --- State: Zip: Phone: BONDING COMPANY: Not Applicable -- Name: Address: City. Zip: Phone: OWNER/ CONTRACTOR AFEIDVIT: Application is hereby made to obtain a permit mit 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 which is in conflict with any applicable Home p yr to build the subject structure structure. Please consult withyourHome ®wnPrs Association rules, bylaws or and covenants that may restrict or prohibit such anon 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 re in accordance with the approved plans, the Florida Building Codes and St. Lucie County respects, perform the work my Amendments. The following building permit applications are exempt from undergoing full g g a ro ncurrency review: room additions, accessory structures, swimming pools, fences, walls, signs, screen rooms and accessoryto another uses ernnn-residential use WARNING TO OWNER: Your failure to Record a Notice of Commencement• improvements to your property. A Notice of G may result in paying twice for Lucie County and y Commencement must be recorded In the public regards of St. y pasted on the jobsite before the first inspection. If ou Intend to ob ' �.,. wit � er or an a before cammencln work o y tale flnancln�, consult �� r recording your N cZ�of Commencement,. Sigrt"of Owner/ Le see/Co actor as Agent for Owner STATE OF FLORIDA COUNTY Df~ - _j Uldlrq Swor -'to (or affirmed) and subscribed before me of ysical Presence or .� online Notarization this day of , 202 by Name of person making statem nt. Personal) Known y OR Produced Identification Type of Ide ification - P ro dAie&d (Sig at f Not ....u:.. u bl ic- St t ° ° � rida SHAUNON WATTS _ _ i MYC0MMIS SION #HN 553 Cgmmission No, X PTES: SEP 16, 2C24 t �v,,�„��i���°�`�" Icugh I St State In�urance REVIEWS FRONT ZONING SUPERVISOR COUNTER R REVIEW REVIEW DATE- REC_EIVED DATE COMPLETED ev,= Sign_'�tife of G tractor ccense older STATE OF FLORIDA COUNTYOF Sworn (or affirmed) and subscribed before me- of Physical Presence or Online Notarization this :day of , 202 b --- y Name of person making stIatelefient. Personally Known OR Produced Identification Type of Identification Prod ' na ur . o o (Sig Lary Public State o SHANNON WATTS ?f'` � My COMMISSION #Hid Commission No. f EXPIRES: SEP 1, Doodad through 1 St State insui ao PLANS VEGETATION SEA TURTLE MANGROVE REVIEW REVIEW REVIEW REVIEW -- -