HomeMy WebLinkAboutIMG_20210922_0005All MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:LI Permit Number:
Building Permit APPlication
Ptanning and DeveloPment Seruices
Building and Code Regulation Division
2j00 Virginia Avenue, Fort Pierce FL 34982
Phone: 17721 467-1553 Fax: (77 21 462-L57 I
Commercial Residential X
Address
Property Tax lD #:C Lot No
Site PIan Name:
Project Name:a
rl
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit - check all that apply:
-Mechanical -
Gas Tank
-
Gas Piping
-
Shutters
-
Windows/Doors Pond
Pitch_ Electric _ Plumbing
-
Sprinklers _ Generator
-
Roof
Total Sq. Ft ofConstruction:Sq. Ft. of First Floor:
-
Utilities:
-
Sewer
-
Septic Building Height:Cost of Construction: $
lf value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
ST. LUCIE
r
PERM IT APPLICATION FOR:CCYI UT-L ,Lo (
\/CLL
IState
Fax:
State or County License
Company
Addre
City:
E-Mai
Zip Code:
Phone No
Fill in fee simple Title Holder on next
from the Owner listed above)
State:
if(
Name
Add
Fax:Zip Code
Phone N
E-Mail
City:
!f value of HAVC is S7,500 or more, a RECORDED Notice of Commencement is required.
Block No. I
CONSTRUCTI ON I N FORMATION :
L
LOCATION:ENTIMPROPOSED
tt ;,
-
Not Applicable
City:
zip
MORTGAGE COMPANY:
Address:
Phone:City:
Phone
e
zip:
-
Not App
Address:
City:
-Not
Applicable
Phone:zip
BONDING COMPANY:
City:
-
Not Applicable
Zip:
FEE SIMPLE TITLE HOLDER:
OWNER/ CONTRACTOR AFFIDVIT: Application is herebv made to obtain a perm
I certify that no work or installation has commenced prior to the issuance of a permit'
it to do the work and installation as indicated
i,'i[ift?fifii1?lr,^ijlf*,T,l3r'fi1J,"fr""[1',fi"lli:i:1s$'li.1i1[?'Gi5]i{#:%"Ih:.:?a'ifl{i'iiit1"-&?3I-,?il?iii!^li.}:,f!t'.'#'."
structure. ptease consuniffiii'fJ,li ij[.,i.i![ilGi; Affi;ilti;ii iiid'-i"vieii vo-tjrtbio-tbi inv iestiictioirs which mav applv'
ln consideration of the granting of this requested permit, I do hereby agree that t will, in- all respects, perform the work
in accordance with the ippr*EJpf*, tnl ftoriOi Building Codes and St. Lucie County Amendments'
as Agpnt for Owner
STATE OF F 4COUNTY OF
Sworn;tothi+L (or bscribed before
20al
me of Physical Presence or
-
Online Notarization
of
Name of person making
Personally Known OR Produced ldentification
Type of cation Produced-T
(Signature
Commission
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ub!P-N ryO0rdFIQtatS 888C]
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5e)IEoTixpim{tl SoClvl a22Ma
MANGROVE
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
PLANS
REVIEW
ZONING
REVIEW
SUPERVISOR
REVIEW
FRONT
COUNTER
REVIEWS
RECEIVED
DATE
SUPPLEMENTAL
State:
Notary Public- State
GGS
#
9122121,6:52 PM
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Saint Lucie County Property Appraiser
Saint Lucie CountY ProPertY
Appraiser
Michelle Franklin CFA
L'PFf ''tr 1fi{Cbrttru&
https://www.paslc. gov/mapl?Parcel tD=3427-70'1 -0O2?-000-2 1t2
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