HomeMy WebLinkAboutBUILDING PERMIT APPLICATION
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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ____________________ Permit Number: _____________________
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:
Address: __________________________________________________________________________________________
Property Tax ID #: _________________________________________________________________ Lot No.__________
Site Plan Name: __________________________________________________________________ Block No. _______
Project Name: ______________________________________________________________________________________
DETAILED DESCRIPTION OF WORK:
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 __ Generator ___ Roof __________ Pitch
Total Sq. Ft of Construction: ___________________ Sq. Ft. of First Floor: _________________________
Cost of Construction: $ _____________________ Utilities: __ Sewer __ Septic Building Height: __________
OWNER/LESSEE: CONTRACTOR:
Name__________________________________________
Address:________________________________________
City: _________________________________ State: ___
Zip Code: ______________ Fax:____________________
Phone No.______________________________________
E-Mail:________________________________________
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name:_________________________________________
Company:_______________________________________
Address:________________________________________
City: ______________________________ State:____
Zip Code: ________________ Fax: __________________
Phone No_______________________________________
E-Mail__________________________________________
State or County 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.
FL
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: ___ Not Applicable
Name:_____________________________________
Address:__________________________________
City: __________________________ State: _____
Zip: ___________ Phone______________________
MORTGAGE COMPANY: ___ Not Applicable
Name:______________________________________
Address: ____________________________________
City: _____________________________State: _____
Zip: __________ Phone:________________________
FEE SIMPLE TITLE HOLDER: ___ Not Applicable
Name:_____________________________________
Address:___________________________________
City:_______________________________________
Zip: ___________ Phone:______________________
BONDING COMPANY: ___Not Applicable
Name:__________________________________________
Address: ________________________________________
City:____________________________________________
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 structurewhich is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit suchstructure. 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 workin 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, consultwith lender or an attorney before commencing work or recording your Notice of Commencement.
Rev. 5/6/20
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Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA COUNTY OF_________________________________
Sworn to (or affirmed) and subscribed before me of
____ Physical Presence or _____ Online Notarization
this ____ day of _________________, 2020 by
___________________________________________
Signature of Contractor/License Holder
STATE OF FLORIDA COUNTY OF___________________________________
Sworn to (or affirmed) and subscribed before me of
____ Physical Presence or _____ Online Notarization
this ____ day of _________________, 2020 by
Name of person making statement.
Personally Known _______ OR Produced Identification ______
Type of Identification
Produced__________________________
___________________________________________________
Name of person making statement.
Personally Known _______ OR Produced Identification _______
Type of Identification
Produced___________________________
(Signature of Notary Public-State of Florida )
Commission No. ______________ (Seal)
____________________________________________________
(Signature of Notary Public- State of Florida )
Commission No. ______________ (Seal)
REVIEWS FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
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