HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
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Rrtilriina Parrmit Annlication
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 CRDG Funding
PERMIT APPLICATION FOR:\�
PROPOSED IMPROVEMENT LOCATION'
�
Address:"
'-_�:
Property Tax ID #: \ \�Q`�f��`� " �j` ` Lot No.
Block No.
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
(Affidavit required)
Mechanical
—Gas Tank
—Gas Piping
_ Shutters
-Windows/Doors
Electric
_ Plumbing
_ Sprinklers
_ Generator
Roof
_
Total Sq. Ft of Construction:
Cost of Construction: $—�
OWN ERAESSEE:
Name
Addre
City:
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic
Stater
'�
Zip Code: ,\'\ t Fax:
Phone No. ��1�1—�'-.SC E-
Mail: C\& om
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
Building Height:
Pond
Pitch
Name: )ci—t f i� C ®a c rL e �� � � • , ��
Company..
Address:`-\�`vvCi\
Cityk r-Itll State:
Zip Code: Fax:
Fax:
Phone No
E-MaiIC�\\L�
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Address:
City:
Zip: Phone:
_i_ ��_ .. _....,...J ;_,+,11,i4n x inrlirntprl
Zip: Phone: __
OWNER CONTRACTOR: Application Is hereby made to obtain a Pefillu
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
wftli lender or an attorney before commencing work or recording your Notice of Commencement.
of Co_gtKac or - or - Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF-'�-�"®'
Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization
this:, day off 1 Mra . 20� by
Name of person making statement.
Personally Known OR Produced Identification *�
(Tyy ,of Identification Produced "fit-t ry s Div
(Signature of Notary Pu ic- State of Florida)
Commission No.
�LA5
REVIEWS
FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Ne
R
Notary Public State of Florida
Lisa M Catalano
My Commission HH 146905
Expires 06/28/2025
.SUPERVIS
REVIEWOR I REV EW I VREVIEW ON I S REV EWLE MREVEWVE