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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:. ;L �/ Permit Number: HECEIVED FEB 012022 St.o - =° Building Permit Application 'P��ng 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 CBDG Funding PERMIT APPLICATION FOR: � ` � 1- Address: o ! Property Tax ID #: 4 I Site Plan Name: Project Name: New Electrical Meter Second Electrical Meter (Affidavit required) Lot No. Block No. 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 _ of Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ Utilities: _ Sewer _ Septic Building Height: .[{8�j j p ai @ �'C 3� 11; K'Y, 1 ie! fM1 � n�� Name t` Name: Address: G ► Company: City: 1 G/C Stater Zip Code: Fax: Phone NJ © _ E- Address: City: State: Zip Code: Fax: Phone No Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail 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. .i .i?�i3"�r �'9.tiF �'Ay 3�,�E'+k",�_-.-'- c�k � ;] � f1�1t' "[�`=ice•' +ai .,.=�'�e'a.rC i�'�' � �5����tie^•i'rv`k i�{x�r� .L�XNI •.•¢� �i y • .. ��'.'ru�.£t .'WK.ra. .2.3, ;�fr1.. . sY�f�.t MORTGAGE COMPANY: _ of Applicable Name: DESIGNER/ENGINEER: o Applicable Name: Address: Address: City: Zip: Phone State: City: Zip: State: Phone: FEE SIMPLE TITLE HOLDER: applicable Name: BONDING COMPANY: �I.et�plicable Name: Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation 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 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 an attornev before commencinL- work or recording vour Notice of Commencement. Signatu Contractor - or - ner BuilcTer as applicable o STATE OF FLORIDA COUNTY OF I side t Swor o (or affirme d s bscribed bef e of h� ysical Presence or Online Notarization this day of - 20 9 l � Name of Arson making statement. Personally Known OR Pro0uced Identification Type)of Identification Produced Ge4 •� 5/701� 1 (Si nat ary Public- State of Flori ) ROSABARAJAS Commission No. zi �;i NotaryPublic-StateofFlorida Commission. 4 GG 3419.85 ''? a My Comm. Expires Aug 11. 2023 Boncec through National Notary Assn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 10/1Z/21