HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �
Date: Permit Number: (9 Iy�r1 • of 19
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:
Address: 5q ZO DC , -(a�'r+ 1�� erce
Property Tax ID#: 3LI02- -Co (6- 045G -(50C Lot No. 10 ' II
Site Plan Name: Block No.
Project Name:_
'1�vnn
11 n U v 2201J f'zcf4-!�,,Je5-
New Electrical Meter Second Electrical Meter
a,Ce- +G nen-i ' R-uncA ; ^ G c.r
(Affidavit required)
Additional work to be performed under this permit -check all that apply:
Mechanical
Electric
_ Gas Tank
_ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ �1660
Gas Piping
Sprinklers
Shutters
Generator
Sq. Ft. of First Floor:
Windows/Doors _ Pond
Roof Pitch
Utilities: —Sewer —Septic Building Height:
Name Bbe_rr•..
Address: c-
City: jj . rC e State:
Zip Code: 04` 1 gZ Fax:
Phone No.IYEZ
E-Mail: e r c, O
Fill in fee simple Title Holcvr on n�4 page (if different
from the Owner listed above)
Name: 61,e '.ems-eS
Company: 1 I
Address:
City: State:
Zip Code: Fax:
Phone No
E-Mail
State or County License
It 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.
SUpME'TIRMUO C}N "IEW111
1
R1�l1An'1,01\IWr �� � f� � `- � rX
-MORTGAGE C
DESIGNER ENGINEER:
/
Name:
X Not
—Applicable_
COMPANY:
Name:
Nle
of Applicable /
Address:
Address:
City:
State:
City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
X Not Applicable
BONDING COMPANY:
x Not Applicable
T
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 lender or an attorney before commenciniz work or recording vour Notice of Commencement.
Sign at Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF -j5A-,
SwoSn to (or affir ed) and subscribed before me of hysical Presence or Online Notarization
this C day of 20c�J by
Name of person ma
Personally Known
TNr6\pf Identification P
statement.
OR Produced Identification
re of Notary Public -
Commission No.
REVIEWS I FRONT
COUNTER
DATE
RECEIVED
COMPLETED
of Florida )
_ (Seal)
ZONING
REVIEW
z ��= 9"Rg& December 2o, 2o22
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SUPERVISREVIEWOR� PLANS REVIEW I VEGETATIEVI WON I SEA REVIEW TURTLE
VEWLE I MANGROVE REVIEW