HomeMy WebLinkAboutBuilding permit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
LLJ CUE
v 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 #: `Jq t'- - EQQ 0 11.77 -f-)00 - j Lot No.
Site Plan Name: Block No.
Project Name:j
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit- check all that apply:
,Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Windows/Doors — Pond
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ _14 e Utilities: —Sewer _Septic
Na
City: X C-+ �'. (LI Cl -c- State:
Zip Code: 734 q'5'2�- Fax.77Z-39ti-2202
Phone No. -7 73 3470 _ ` —?z S
E-Mail: �Y'L'S�z 1�/F�lr� / C-&ITY► rd(t. Y1�Fj
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Roof Pitch
Building Height:
Name::jCVT
Yj V,
Company: C& I {�
Address:15120 SIC
City: Stat
Zip Code. r--), Fax7yG� Z 7
Phone No - 7-7 7- cm z 5
E-Mail ' Yi" vl "c 16—
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State or ounty 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.
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:_
Address:
City:_
Zip:
Phone:
wwwnlCn/ �-VIY 1 MAL 1 vn AMUV1 I : 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 hpfnrp rnmmonrina %e/nrb nr rarnrriinn %n it Kl^+;..,, ..F r,...,...,.,...,........,._�
Si f Owrr /rf Lessee/Contractor as Agent for Owner
Cont ac or/License Holder
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STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA
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COUNTY OF
Swoyn to (or affirmed) and subscribed before me of
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Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this �--r- day of 0Hy' 20Z i by
Physical Presence or Online Notarization
this k'day of P2f " 2021 by
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Name of person Inaking statement.
Name of person liaking statement.
Personally Known �� OR Produced Identification
Personally Known V� OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
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(Signature of Notary Publi
(Signature of Notary Publi
Notary Public Stab of FWM&
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Commission No. Myi 4LasanGG963069
yt Notary Public State of Florida
ommission No. ;� Cra{�@�3rossman
Expires O5110/2024
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RECEIVED
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DATE
COMPLETED
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