HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
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Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Commercial
CBDG Funding
PROPOSED IMPROVEMENT LOCATION:
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Address: 2_
Property Tax ID #:
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
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Resmident'19a
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Lot No,.
Block No..
VVA C�� V%kl-
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IL eF 2.1 C2 OO S it /0000'r
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New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this perm
l
Mechanica
Total Sq
Cost of
Gas Tank Gas
Electric _Plumbing _Sprinklers _
Sq. Ft,, of First Floor:
Utilities: _Sewer _Septic Building Height:
check all that apply*.
. Ftof Construction:
construction: $
OWNER/LESSEE:
Name
op
Address:
city: �.-,� 1 tf::��L
Zip Code:
Phone No.... ILL
Mail:-
Fill infee simple Title Holde
Fax
r on ne
from the Owner listed above)
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State:
2 ±ho
a. a
(if d Ifferent
or CONTRACTOR:
Name: cL.z�
Company: VP.
Address: SL,1� Y.,4c/
City: � e
Zip Code:
Phone No
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State or County License
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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.
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IP
State
Shutters
Windows/Doors
Pond
Generator Roof Pitch
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SUPPLEMENTAL CONSTRUCTI9 LIEN LAW INFORMATION:
-
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phonet
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phonelb
:
OWNER/CONTRIIIIIIIIIIIIACTOR LFFIDIIIJIT: Application is hereby made to obtain a permftto do the work and installation as indicated.
1 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 consult with 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
WAREFNING TO : Your failure to Record a Notice of Commencement may result i n paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted o n the jo bsite before the first inspection. If you intend to obtain financing, consult
with lanripr or an attorney before commencine work or recording your Notice of Commencement.
Suture of Owner/ Lessei/Contracto
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirm
this
day of
r as Agent for Owner
nd.subscribed before me of
eY{/1/LQ (� n �
Name of person making statement.
Personally Known OR Produc-P. I entification
Type of Iden*ation Produced
(Signature of Notary Public- State of Florida)
W
commission No.
(Seal)
AD
hysical Presence or Online Notarization
�353�
4 ;� 3 a co 4 Q
ANDRE OLIVER SILVERA
Notary Public, State of Florida
CommissVonp HH 7433
W Comm. ex#res Sept. 28. 2024
REVIEWS FRONT ZNINGI EGETATIEA TU RTANGRO
COUNTER I REVIOEW IS
REVIEWUPERVISOR I REVIEWPI NS V
REVIEW ON I S REVIEWLE
I M
REVIEWVE
DATE
RECEIVED
DATE
COMPLETED
ev 5/20/Zl