HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
ST. L CIE
COIi.N�T�Y
F L O R I a D A
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
(U
PROPOSED IMPROVEMENT LOCATION:
Residential
Address: M19 �
� Cti
Property Tax ID #; c - Lot No. c! �
_ lh • ��3�� Block No.
Site Plan Name: I
Project Name:
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter I
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical
_ Gas Tank
— Gas Piping
_ Shutters
_ Windows/Doors
_ Pond
Electric
'J Plumbing
_ Sprinklers
_ Generator
_ Roof
Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 51,5,)0
OWNER/LESSEE:
Name
Sq. Ft. of First Floor:
Utilities: Sewer _Septic
CONTRACTOR:
Address:�:CN 011,16fl _
City: ,1 i e- State: FL
Zip Code: Fax: _g
Phone No. l ^ — 10 1
E-Mail: LJl�fw�i�
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
1
Building Height:
Company: JVN
Add ress:-J,QNS az
City: �r�� L1J�C\Q ' state: —EL
Zip Code: Fax: ZYZ -
Phone No — 4 9 4
E-Mail Q&r , AS
State or County License
e+ /
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X 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.
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
structure. Plconflict nsult withpyourHlome Ownne s Association and review deed far any restrictions ovenants which may strict aprohibit such
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 commencing work or recording our Notice of Commencement.
42
gnature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
Swprn to (or affirmed) and subscribed before me of
V physical Presence or Online Notarization
this 2 E� day of ��2026 by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced a," V Ii
f%Bwd�ed
tary Public - State of Florida
Commis Commission M HH 4482[6ea
omm. pares Oct 1, 2024
through National Notary Assn.
REVIEWS I FRONT ZONING
} COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
5ywrn to (or affirmed) and subscribed before me of
.Physical Presence or Online Notarization
this r day of , 2020 by
11ArA+A- 2;Ls 1L -
Name of person making statement.
Personally Known ✓ OR Produced Identification
Type of Identification
Produced
(Sig ture ublic1:121*10
Notary Public State of Florida
Commission # Hai 44���,
Commission Aires Oct f141
Bonded through National Notary Assn,
VE
S REVIEWOR REVIEW PLANS I VEGETATIEV EWON I SEATURTREV EWLE MRE IV EW..