HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BF ACCEPTED
Date: '� � Permit Number: ,2,2, -
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Bufading Permit Application
St -Lucie County
Planning and Development Services P r itting
Building and Code Regulation Division Commercial Resid.ential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553,Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
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Address: �3Q
Property Tax ID #: o2�!�CP rC� d�- 0- 3 `�o0U — Lot No.
Site Plan Name: Block No. .
Project Name:
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New Electrical Meter X Second Electrical Meter (Affidavit required)
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Additional work to be performed under this permit - check all that apply:
Mechanical Gas Tank _ Gas Piping _Shutters Windows/Doors Pond
,� Electric _ Plumbing _ Sprinklers _ Generator — Roof Pitch
Total Sq. Ft of Construction: %(�JU Sq. Ft. of First Floor:
Cost of Construction: $� G�� Utilities: --Sewer _Septic Building Height:
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Name
Name: R u �--eC + L v i.c L-
Address: G
Company: C r"C,
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City: FCI- T I" t C �e State: tC_
Address: 9(CSi Z'-IO,(v cr-
City: PS �- State:
Zip Code: 3!9 Fax:
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Phone No. %7o?- �a0 _l�f�' S� E-
Zip Code: �3 Fax:
MailAk C/de, cl, Cam-
Phone No
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Fill in fee simple Title Hnp/.er on next page {if different
fzoen the Owner listed above)
State or County License CCU %306 9 y
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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.
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DESIGNER/ENGINEER: v _ Not Applicable
Name:
_ Non-
MORTGAGE COMPANY: Not
Name:
Address:
City:
9
Applicable
Address:
City: State:
Zip: 'II -'Rhone
State:
Zip: Phone:
PEE SIMPLE TITLE MOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not
Name:
bpplicable
-
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain, a permit to do the work and install tion 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 mayZrk
ply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the
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-resid ntial 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 pubic records of St.
Lucie County and posted on th(e'I{ngJbsite before the first inspection. If you intend to obtain fi p ancing, consult
.[i.I_ 1_._ J__ .�.. _.,,.-.11...-.�1-1 "..C#r�rNi^n-Alnnrina Wnrlr rr rPr•ni-ding vnur Notice of Commencement.
WILII Ienuel VI all aLLUI I I U I Zvi �u -
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Signa ure of Contractor - 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 of 20_ by
Name of person making statement.
Personally Known . OR Produced Identification
'Type of Identification Produced
(Signature of Notary Public- State of Florida)
Commission No. (Seal)
REVIEW=FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION I
SEATURTLE
MANGROVEREVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW -
DATE
RECEIVED
DATE
COMPLETED
Rev