HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I Q LI V u oa l Permit Number: _
� '
G Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Commercial Residential _X,
CBDG Funding
I PROPOSED IMPROVEMENT LOCATION: I
Address:
Property Tax ID #: Lot No.
Site Plan Name: c Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator _ Roof
Total q. Ft of Construction: _ Sq. Ft. of First Floor:
ff Cost of Construction: $ * 1 o d Utilities: , Sewer _ Septic Building Height:
Pitch
OWNER/LESSEE:
CONTRACTO ;
Name
Name:
Address: %
Company:
City: -- State:.-
Address:
Zip Code: Fax:
City:
State: PU
79 Phone No. E-
Zip Code: 3�` -f" ) Fax:
mail: ---
Phone No .2- UP) CItI
Fill in fee simple Title Holder on next page (if different
E-Mail
cYs
C
State or County License
e- . 1-3
from the Owner listed above)
if value of construction is 25M 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION,
DESIGNER/ENGINEER: _._ _ Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City.
Zip: Phone:
w vvlrcni %.Urv' K04[.1 UK ArrW V i i : Application is hereby made to obtain a permit to do the work and installation as indicated.
1 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 anaatxerrtey EZefore coxnncing work or recording your Notice of Commencement.
STATE OF FL
COUNTY OF
Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization
this Iffday of,20.9}, by
Name of person making
Personally Known V_ OR Prq}uced identification
Tvne of
(Signature of Notary Public
�-q o Florida }
Commission No. )2 t� (Seal)
REVIEWS FRONT ZONING,
COUNTER REVIEW
Notary Public - State of Florida
Commission # HH t 28967
My Comm. Expires May 11, 2025
ec throLgh rationa. rotary Assn.
SUPERVISOR I PLANS I VEGETATION 1 SEA TURTLE I MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW
ELECTRICAL MISER PLAN
MOTTO SCALE
FPL Requi —YES or NO (circle one)
FPL Account Number
Meter Number and Picture /� C q_
_.
1. ;Size Service L 20G
2. - Conductor Size I---�
3. a. Meter Main
b. Meter Can Only:
GROUNDING ELECTRODE CONDUCTOR SIZE:
a
a#2
El Other
CONSTR ON TYPE:
.9 Residential
n Mobile Home
New Installation
Old installation
,�Qc1e s2vv,ce NOTES: t�C�r^ �;� vo a06 N't 95 , pme 4y-' 'Z=sev l anal e �