HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
LLi cLL
4 e , L —' -
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1S53 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Commercial Residential
CBDG Funding
PROPOSED IMPROVEMENT -LOCATION:
Address: 11,e3 /k ryf�`�
Property Tax ID#:
Site Plan Name:
Project Name:
DETAILF,DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
Lot No.
Block No.
Additional work to be performed under this permit— check all that apply:
_Mechanical tumbing
Tank _ Gas Piping Shutters Windows/Doors Pond
Electric _ Sprinklers _ Generator Roof
Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $r�Q, Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE: � CONTRAFOR•
Nam .4h ) rt- �s ICE
Name:
Compa
State:
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
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.
Name:
Addresi_;�
City:
Zip: Phone
FEE SIMPLE --TITLE
?LE pL�E
Name:
Address:
City:
Zip: - Phone:
yw rame MORTGAGE COMPANY:
Name:
Address
State: City:
Zip: P ne:
_ Not Applicable I BONDING C PAniv_.
Name: s
Address:
City:
Not Applicable
Scat
Not Applicable
L----- I Zip:_ Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work a
I certify that no work or installation has commenced prior to the issuance of a permit. nd installation as indicated.
St. Lucie County makesnore r able
Morn that is ra gg
structure. Please consult PC Homeowners�ssociaTiopeuleis, bylaws ore dtcovenan
permit holder to build Cher prohibit structure
Your Homeowners Association and review n is that may restrict
In consideration of the granting of this requested permit, I do hereby agree that el will, in aed for ll respects, perform thepw hk 1t such
in accordance with the approved plans, the Florida Building Codes and St. Lucie County restrictions which y apply.
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 improvements to our Property.
Lucie County and posted on the a cone before the first inspection. If you intend to obtain financing, consult
P P rty. A Notice of Commencement must be recorded in the Public records of St.
ice for
with lender or an attorney before commencing work or recording vour
or • Own eras
STATE OF FLORIDA
COUNTYOF
savor o {or afflr dJ and subscribed befpte me of thisay of� Z yt by _ Physical Presence ar
`vim y Online Notarization
person making statement.
Personally Known \/ OR Produced Identification
Type of Id�icatiaA Pfo �ced n
—. ��
Commission No.
REVIEWS FI� '�'q� '
COU SUPERVISOR
REVIEW VEGETATIONJSEA
EVTU
EWLE MANGROVE
'ATE /NIIfl1111N1N\ a REVIEW
ECEIVEO _ REVIEW