HomeMy WebLinkAboutapplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ?.). 2 3' Permit Number:
YF^ 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 CBDG Funding
PERMIT APPLICATION FOR: '\l? vi l
1*11~04EN,,T\LOCADON:
Address: 1 Zq / 144 v Gv` C�'^) C--
Property Tax ID tt: 3IMCDt . 5 30 - d Z . C00 - Lot No.
Site Plan Name: UWPW\ _ 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 _ Windows/Doors _ Pond
Electric /Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction:: , 3,T Sq. Ft. of First Floor:
Cost of Construction: $ I 1 ` 06. 00 Utilities: -Sewer _Septic Building Height:
l7WNORILESSEE.
Name 0;N L
Name:
Address: /29 Nar ztlP.4-4,✓J6
Company: ✓ 2GS
City: en / .TS lNC.w State: £G
Zip Code: Fax:
Phone No. 7/E `/E-
Address:
City: State
Zip Code: 34qq, f_ Fax:
Phone No�'L Zl��j ' Y-Lu
Mail: Dt,6Q
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
If value of construction is 75nn nr .o...e . ocrnoncn u_..__
E-Mail to-r
State or Couniy Cicense�
unea.
If value of HAVC is $7,500 or more, a RECORDED Notice Of Commencement is required.
n .�.:•: : r,
- . i��,, �;t'.���t.rtN LiCl°7'e.'���liR#TA��L ; -
DESIGNE
Name:
EN INEER:
19
Not Applicable
1 V h
MORTGAGE COMPANY: _ of Applicable
Name:
Address:
Address:
City:
Zip.
Phone
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER:
Name:
_ Not Applicable
BONDING COMPANY: _ of Applicable
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 conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consu t w applicable your Homeowners 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 )obsite before the first Inspection. If you intend to obtain financing, consult
with lender or an attornev before commencing work or recording vour Notirp of Cnmmpnrpmpnt
Signature4L��
of Owner/ Lessee/Contractor as Agent for Owner
-
STATE OF
COUNTYOFORIDA Ef I'LG;%
rn to (or affirmed) and subscribed before me of
Swohei
Physical Presence or Online Notarization
this day of 04A 11 �.e . 20 1 by
Name of person making statement.
Personally Known '>'� OR Produced Identification
Type of Identification Produced
(Signature of Notary Public- State of Florida)
State M Florida
Commission No. t6 NNW (Seal)P
ry, Notary Punae
`t• Pwest
,, lion GO 312804
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d� Expires 0311712023
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Rev w2uy22
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61
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
• - BUILDING & CODE REGULATIONS DIVISION
Survey Reauirements
The Board of County Commissioner approved a code change that will require a copy of a current sealed
survey when applying for a building permit for a primary structure or a building permit for an accessory
structure with a value exceeding $10,000. This became effective Julv 1, 1993.
The guidelines are as follows:
No Building Permit shall be issued for development unless a copy of a survey of the property on which
the required activity is to be permitted accompanies the application for building permit. All surveys shall
demonstrate compliance with the Filled Lands Affidavit signed by the Property Owners (refer to St. Lucie
County Land Development Code, Section 7.04.0LD.3.) and completely depict the following:
1. The location of the proposed development activity.
2. The relationship of the activity under application to all adjacent property lines, and as may be
required for the review of the application, all adjacent structures, improvements or natural
features, including but not limited to the nearest building corners of all adjacent primary and
accessory structures, pools and screened enclosures, fences, sheds, utility easements, wells, septic
systems, driveways, culverts and any landscaping or existing vegetation located along the
property lines.
3. A minimum of two (2) elevations along each roadway on which the proposed activity borders, the
existing ground elevation at the approximate center of the proposed structure, the existing ground
elevation along the side property lines adjacent to the proposed structure, and the proposed
finished floor elevation of the structure under application and finished grades for any adjacent
structures rioted above in item 2. The proposed finished floor elevations must be consistent with
the approved Health Department On -Site Sewage Disposal System Construction Permit if on -site
sewage disposal is proposed.
All surveys submitted shall be prepared, signed and sealed by a Florida Registered Land Surveyor, in
accordance with the provisions of Chapter 61G17-6, FAC, except those applications for interior
modifications or construction, roofing permits not involving any structural alteration or additions to the
area covered by the roof surface, or any other permit required activih that does not result in the expansion
of any portion of the existing structures shall not be required to submit a survey, Accessory structures
with a building value of less than ten thousand dollars ($10,000) shall not be required to submit a survey,
but shall instead be required to submit a scaled plot plan indicating the location of the accessory structure
and its compliance with minimum setback standards. Copies of original surveys meeting the above
requirements may be submitted with any application for building permit, provided that the survey still
depicts the accurate location of all structures and other improvements on the properly.
Per Florida Administrative Code Chapter 61G17-6.006, paragraph 8, additions or deletions to
survey drawings by other than the signing party or parties is prohibited without written consent of
the signing party or parties.
SLCPDSD Rcv 06/l8/2010
219/06 cml