HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll 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
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Commercial Residential
PROPOSED IMPROVEMENT LOCATION:
Address: 4411 N
Property Tax ID #:
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
M.I■uIE
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
Lot No.
Block No.
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters Windows/Doors Pond
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:�l_(�
Cost of Construction: $ 2%,57
OWNER/LESSEE:
Generator Roof 5 Z Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic
Name
Address: d )(t(A ems.
City: Stat�Q
Zip Code: �(,¢ Fax: _►
Phone No.
E-Mai: e C COrd��rvtQt�.c�
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Building Height: ZO
Name:
Company:
Addresss7 v
City: State9-TD
Zip Code: �3 3q 0 Fax:
Phone No ' - ((4 q�
E-Mail &a k E 1 yG ca�
State or County License (- P14— /32r9"
f value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
f value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
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 per t a plications are exempt from undergoing a full concurrency review: room additions,
s, swi ing ools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
accessory*eCer
WARNIWN : You failure to Record a Notice of Commencement may result in paying twice for
impts t your roperty. A Notice of Commencement must be recorded in the public records of St.
Lucian poste on the jobsite before the first inspection. If you intend to obtain financing, consult
withor a attor ey before commencing work or recording our Notice of Commencement.
Signatur of Owner/ Lessee/Contractor as Agent for Owner y. Notwy Pubk Stais Of Fbri
Nadine Dupre
STATE OF F LO R I DA6 y : _ My Commission HH 078293
COUNTY OF > Ex m011o7rm2s
Swor to (or affirm d) and subscribed befRr'e me of Physical Presence or Online Notarization
this day of 20sU by
. LlLll
Name of person making statement.
Personally n OR Pro d 14 tif'cation
Type of dentification Produced
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 5/20/21