HomeMy WebLinkAbout2020 SLC Building Permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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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:
ROO
Address:
Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name
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New Electrical Meter Second Electrical Meter
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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:
Name Name:
Address: Company:
City: State:_ Address:
Zip Code: 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.
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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
improvem our property. A Notice of Commencement must be recorded in the public records of St.
Lucie C unty and po ted on the jobsi be€ce first inspe ou intend to obtain fi ng, consult
with len ran orne bef commencin work or r cordin ou Notice of mencement.
Signa ure of Owner/LesseeJC ntractor as Agent for Owner Signature of icense Holder
STATE OF FLORIDA STATE OF FLORID
` .COUNTY OF iC x COUNTY OF !3A u
Sworn to(or affirmed)and subscribed before me of S% to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization Physical Presence or Online Notarization
this ay of 12024 by this ay of ,2024 by
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Name of person m g statement. Name of person ma��011
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Personally Known OR Produced Ide if�ation Personally Known Produced Identification
Type of Identification LL c Type of Identification
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REVIEWS FRONT ZONING WA V OR PLANS VEGETATION SEATURTLE
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DATE
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