HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO-BE ACCEPTED
Date: . Permit'Number:
Was -
Building Permit Application }
Planning and Development Services I
' Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:-(772)462-1553 Fax: (772)462-1571;_"'CBDG Funding
PERMIT APPLICATION FOR: ;
93 Address:
Property Tax ID#: boat-d Lot No. o
Site Plan Name:' Block No.
Project Name:, . ^
l -
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 =Poridr":,
Electric _Plumbing _Sprinklers _Generator Roof Pitch
Total S Ft of Construction:, `q. v Sq. Ft.of First Floor: }
Cost of Construction:$ Pe Utilities: _Sewer Septic Building Height:
'_Name . L - - - ;.Name':
Address: "ZS' �� s; o Company:, 44
City: t a,state Address:
Zip Code: Fax: City: State .
Phone No. E- Zip Code: Fax:
Mail: Phone No
�-177 7,r7545i 2; , �f
Fill in fee simple Title Holder on next page if different E-Mail r
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$1,500 or more,a RECORDED Notice of Commencement is required.
rS'a4' P
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 hold&-to build the subject-structure
'o which conflicts with any applicable Homeowners Association rules,bylaws or and covenants tfiat may restrict or prohibit such
structure.Please consult with your Homeowners Association•and,review.your deed for any restrictions which may apply.
t
In consideration of the granting of this requested permit, I do hereby agree'ihat 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,
i 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 in If-you intend'to obtain financing, consult
with lender or an attorneybefore commencin work or recordin our Notice of Commencement.
Signature of wner/Lessee/Contracto as Agent for Owner
STATE OF FLORIDA
COUNTY OF Ly .
Sworn to(or affirm )and subscribed befo a me of Physical Presence or Online Notarization '
this�day of b�. 20 by
Name of person making'st�atement.
' Personally Known � OR Produced Identification
Type/Identification Produced
i
.( ig ature of Notary Pub[ tate o Florida)
HEATHER BURFORD
Commission-No.- - --'.(Seal). : .• ' - '; .`.P"Y°�a�., -- •- ,. - .
=° State of Florida-Notary Public `
Commission-# GG-183217- `
F arc M
• ,. _ '� ��ijEOFFI��� YTommission Expires_
February 06, 2022 -
REVIEWS FRONT ZONING - SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED. '
DATE
COMPLETED
Rev 5/20/21