HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICKnON TO BE ACCEPTTEQ
Hate: Permit Number.
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L.y 1 tY�'Rvgi it
Building Permit Application
Planning and Development Services
Building and Code Reguiation Divisibn Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CB®% Funding
PERMIT APPLICATION FOR: �ncc `1
PROPOSED IMPROVEMENT LOCATION:
Address: r
Property Tax ID ##: _ s Lot No.
Slack Na._
Site Plan Name: I —
Project Name:
DETAILEDDESCRIPTION OF WORK
1
.i +� l -
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to he performed under this permit —check ail that apply:
Mechanical _ Gas Tank — Gas Piping _ Shutters _ Windows/Boors — Pond
Electric Plurrtbi€ e _Sprinklers _Generator _Roof _Pitch
Total Sq_ Ft of Construction- Sq. Ft. of First Floor: —
Cost of Construction: $ Qq(n • Utilities: —Sewer _ Septic
Building Height:
IfIf value of construction is z,5uu or more, a Kte.ueetstts MOXICe OI tcyunc
if irniris. of t4Aur is 4.7 9ftn nr mnrn a 62Ff( Rnirn &tntira of rnmmanramant ie rPnrrirard
SUPPLEMENTAL CONSTRUCTION LIES LAW INFORMATION:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: ----------- Phone:
DESIGNER/ENGINEER: — Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: — Not App€icable
Name:
Address:
City:
Zip: Phone:
Name:
Address:
City:
Zip, Phone:
— Not Applicable
State:
Not Applicable
OWNER/ CONTRACTOR AFFIQ IT: Application is hereby made to obtain a permit to do the,work and installation as indicated.
i certify that no work or instaii•- ion has commenced prior to the issuance of a permit_
er
ld
St. Lucie
conflicts imakes th anynappf�cahie >iomeownersgMo-itciat on rules,�bylaauthorize
s or and covenants that to
restrictorosubject
prohib structure su
structure_ Please consult Ivrth yo€sr t#orneowners Association and review your deed for any restrictions which may apply_
In consideration of the granting of this requested perm
f do hereby agree that 1 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 ap tlisatio-is are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen morns and accessory uses to another non-residential use
result in
WARNING TO OWNER: your
property- failure t A Notice of Commencement must be a Notice of Commencement yrecorded paying the pubic records of St.
improvements d your don the
Lucie County and posted on �e;obsite before the first inspection_ if you intend to obtain financing, consult
vnrifh fender or an attorney before commencing work or recording our Notice of Commencement.
Si attire o Owner Le ee/Contractor as A nt or Owner
STATE OF FL 10
COUNTY 0F4 .��`--r
Swgrrbij 4r af6[�ed and ubscribed be rre me of JPhysical Presence or Online Notarization
this` day of � 1 / 20L .Lby
Name of
Personally Known
Type of Identificai
statement_
OR Produced
{Signature of Notary Public- State of Florida)
Commission No_ AC-r-I � Sear
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
REVIEW
MANGROVE
REV!
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
BATE
RECEIVED
DATE
COMPLETED
—
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