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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 Date: ic0'-1- a1 Permit Number: REeEIVED �� OCT 0 7 2020 7 c n St. Lucie County � av_ Building Permit Application Permitting 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 CBDG Funding PERMIT APPLICATION FOR: Address: 2 1 L�� 0%-/ d/ I Property Tax ID#: �����0 �" (iC OLJ`J' Site Plan Name: 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 indows/Doors Electric _ Plumbing _ Sprinklers _ Generator _ Roof Total Sq. Ft of Construction: Sq. Ft. of First Floor: _ Cost of Construction: $ D O O Utilities: —Sewer _Septic Lot No. Block No. Building Height: Pond Pitch Name Name: Address: i C C D /1— Company: City: C'9127-- 'r R-CA- State: Zip Code: ? �tj Y 0 Fax: Phone No. © .� E- Address: City: State: Zip Code: Fax: Phone No Mail: ? I�--;;-I RC-E ( Cj ROO I -ft`-' Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail 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. DESIGNER/ENGINEER: _ Not Applicable Name: _ Address: City: Zip: Phone FEE SIMPLE TITLE HOLDER Name: Address: City: Zip: Phone: State Not Applicable MORTGAGE COMPANY: Name: Address: City: Zip: Phone: BONDING COMPANY Name: _ Address: City: Zip: Phone: Not Applicable te: Not Applicable 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 conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Homeowners 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 wit[/lender or an attornev before commencing work or recording your Notice of Commencement. S' nat re.of Own / Lessee/Contractor as Agent for Owner STATE OF FLO IDAi_ COUNTY OF Sworn o (or affir a d subscribed before me of Physical Presence or Online Notarization this day of _rn2Q� by Name of person making statement. Personally Known OR Produced Identification Type of Identification Produced (Signature of Notary Public- State of Florida) S. NIELSEN Commission No. (Seal) f Florida -Notary Publicission # GG 207484Commission ==- ExpiresJune 12, 2022 REVIEWSREN REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW' REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 5/20/21