HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 71S 17 i Permit Number:
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
PERMIT APPLICATION FOR:
Address
Property Tax ID #: 34 14 - 5 10 - 0076 -000_ 1 Lot No. c'
Site Plan Name: 32$ Sh" Ln 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 e Pond
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: tt Sq. Ft. of First Floor:
Cost of Construction: $ 1 1 00 Utilities: —Sewer _Septic Building Height:
Name An LAV- re
Addre5s:3Z6 h ti LCA.ne-
City: Of'r S l,• .yC\e State:
Zip Code: (- 9 52 Fax: VI
Phone No. % 6 - 7 %3 S
E-Mail: biS " C,CM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: I If'
Company:aucL`1 rct C Gec- erv1 cel
Address: q Z Cti-{�' ee v • u�
City: T ► tus V-d i e State: L
Zip Code: 32-7'� 0 Fax: b1A
Phone NoT/2 - 232 - 70 I q
E-Mail Ce Oar ,erv\CeS v4a160
State or County License C � C t 32aq o3
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.
x
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
7X
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: 4- 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
is in
which 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 po d on the jobsite before the first inspection. If you intend to obtain financing, consult
with lend rneV before commencing work or recording our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OFeUQ y-C'
Sworn to (or affirmed) and subscribed before me of JV, Presence or Online Notarization
-Physical
thisday of 200 \ by
A)1 .1( C_ e
Name of person making statement.
Personally Known V OR Produced Identification
Type of Identification Produced
(Signature of N ary Publi tate of Florida )
of Florida
Green
Commission No. 6 (Seal)
/ ��=�/2024
My Commission
04191544
4
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.5/20/21