HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONUJ erfPERM IT APPLICATION FOR:
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Fax:
Company
State or County License
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Zip Code:
City:
from the Owner listed abovel
Name
Fill in fee simple Title Holder on next page { if different
City
Zip Code:
Phone
E-Mail
All MUST BE COMPLETED FOR AFPLICATION TO BE ACCEPTED
Permit Number:
Date:
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Planning ond Development Services
Building and Code Regulotion Division
23OOVirginia Avenue, Fort Pierce fL i4982
Phone; 1777\ 462-L553 Fax: (772\ 462-1578
Building Permit APPlication
Commercial
-
Residential
Address
Property Tax lD #:Lot
Site Plan Name:Block No
Project Name:
New Electrical Meter Second Electrical Meter (Affidavit required)
Additional work to be performed under this permit * check all that apply:
-Mechanical -
Gas Tank * Gas Piping -
Shutters
_ Electric -
Plumbing * Sprinklers
-
Generator -
Windows/Doors
Roof
Pond
Pitch
Total Sq. Ft of Construction Sq. Ft, of First Floor:
Cost of Construction: S Utilities: _ Sewer -
Septic Building Height:
lf value of construction is 2500 or more, a RECORDED Notice of Commencement is required
lf value of HAVC is 57,500 or more, a RECORDED Notice of Commencement is required.
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LAWNTAL N:INFORMATIOLIENSUPPLEME
State:
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Address:
City:City:State:
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BONDING COMPANY:
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Not APPlica bleFEE SIMPLE TITLE HOLDER:
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The following building Permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structuret swi mming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
result in paying
in the
twice for
public records of St.
obtain fina ncing, consult
IIttttIlLtlr
Personally l(nown
-OR
Prsduced ldentification Y
Holder
Commission
cou NTY OF
or
by
statement.
of
and subscribed before me of
Online Notarization
Name of person
STATE OF
i,rv Comm. Erpires Dec 29. 202r
Pu b lic (r!r6 ^i ;l^-.r.
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Sworn to {or affirmed} and subscribed before me of
Name of person making statement.
Personally Known
-OR
Produced ldentiftcation *{
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as Agent Owner
No.
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this ?Pl.6sy
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COUNTYOF
STATE OF
REVIEWS FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPTETED
CONSTRUCTION
Zip: