HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION T0 BE ACCEPTED
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Sfur;ELGHE--.,iHa Building Permit Application
Plann.ing and Development Services
Building and code Regulation Division Commerc ial .~ Residential
2300 V'Irg'Inia Avenue, Fort P.ierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 CBDG Fundin8
PER,1,-I,.`.,,-,-.^\*-,M IT AP PLI CATI O N FOR:
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Site plan Name: is(fl^ri fj a ni`wh) BiockNO.
Project Name:
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New Electrical Meter Second Electrical Meter (Affidavit required)
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Additional workto be performed underthis permit-check
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Mechanical Gas Tank Gas piping Shutters _ Windows/Doc]rs Pond
Electric Plumbing _ Sprinklers Generator Roof Pitch
Total sq. Ft of construction: Sq. Ft. of First Floor:
Costofconstruction:S qc7i£. Cacj Utilities: Sewer _Septic BuildingHeight:
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11[1Fill in fee simple Title Holder on next page (if different E-Mail r)hpfo ) )ro Cia-C}-r -r` Cn;'vi>57Z
from the Owner listed above)stateo!couffiJLicen'seftrr lfr|T C-- .L '*'.)
lf 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/E NGINEER: Not App icable MORTGAGE COMPANY: Not Applicable
Name:Name:
Address:Address:\
Zj':¥: Phone \\ \tat\City: ( \\ state :
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LEaEms:YPLE T'TLE HOLDER: REt rp Tc\b,e R:mNep,NGCoNv:fN°tAPplicab|e
ress: I Address: ) ' ''
C,ty: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.
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ln 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
ents to your property. A Notice of Commencement must be recorded in the
on the I.obsite before the first inspection. If you intend to obtain financing, consult
before commencin work or recordin
public records of St
our Notice of Commencement.
Signature of Contractor -or Owner Builder as applicable
Personally Known
Type Of
v' OR Produced Identification
tification Produc
Commi =8T-%`t, 7 ,.;RE[;:JOAN "YER
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ExplrosD~9.2022
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REVIEWS FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED