HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8/13/2021 Permit Number:alU_
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Building Permit Application in9pepartment
Planning and Development Services bermLuctie CpuntY
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Building and Code Regulation Division Commercial. x Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
pROPOSED'IkM4PROVEM:ENT LOCATION'.
Address: 201 S. Indian River Dr. Ft. Pierce, FL 34950
Property Tax ID#: 2410-509-0005-030-1 Lot No.
Site Plan Name: Clerk of Courts Building 3rd &th floor Block No.
Project Name: Clerk of Courts 3rd and 4th Floor Remodel
DETAI LED-DESCR'IPTION OF WORK
Demo of existing walls, relocating of existing and installation of additional E2 walls per plans. Relocating of existing lighting,
floor boxes and door swipe card readers. Replace flooring (4th floor)
New Electrical Meter Second Electrical Meter (Affidavit required)
CON,ST,RUCTIO'N INFORMATION"'.
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: Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: —Sewer —Septic Building Height:
OV1/N ER/LESSEE. CONTRACTOR:
. t
Name % Management&Budget Name:
Address: 2300 Virginia Ave Company:
City: Fort Pierce State: FL Address:
Zip Code: 34982 Fax: City: State:
Phone No. Zip Code: Fax:
E-Mail: Phone No
Fill in fee simple Title Holder on next page( if different E-Mail
from the Owner listed above) State or County License
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,LTN 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 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.
Signature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF 111�7 LGi
Sworn to(or affirmpjd)and subscribed before me of Physical Presence or Online Notarization
this /-7 day of /'U&ySd' 20Z4� by
Name of person maiding statement.
Personally Known ✓ OR Produced Identification
Typ of Identification Produced
(Signature of Notary Public-State of Flon .......... MELISSAS.80ECKEL
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Commission#GG 9809A
Commission Noga I F61960 ( `I :o�=Expires April 23,2024
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DATE
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DATE
COMPLETED
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