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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Permit Number: O �` Date: Building Permit Application-. 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: Address: Property Tax ID #: Block No. Site Plan Name: Project Name: 'T)'V t/A kWA PA 06� New Electrical Meter Second Electrical Meter (Affidavit required) "i}l,k: T C '�ii `s.'"�G�"'P'` ��.�Ja'46 tl f ��- gg c Additional work to be performed under this permit - check all that apply: Mechanical Gas Tank Gas Piping —Shutters _ Windows/Doors _.Po.nd _ lectric — Plumbing —Sprinklers — Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ 2.2®©' �� Utilities: — Sewer Septic Building Height: � .�"-.+�' F ��?�a' '§ i 3 � - _ ..&� L n-,.'jr -�•� Fkf r R., .�. .» .1't.rTJ� a � 5 Name: _ l� F _ Name �. !) Address: 066 057- Company: City: _ State: Address: City: �� ��• State: Zip Code3 5?,- Fax: Phone No. E- Zip Code: 3YFOpZ— Fax: Mail: Phone No :ZZ-- Fill in fee simple Title Holder on next page (if different E-Mail eC e C f^7l-lCC State or County License � f -IT 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. Z M DESIGNER/ENGINEER: _ Not Applicable Name: _ Address: City: Zip: State: Phone FEE SIMPLE TITLE HOLDER: Name: Address: City: Zip: Phone: _ _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: Not Applicable Name: . Address: City: 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 installati� ;n has commenced prior to the issuance of a permit. St: Lucie County,makes,no representation that is granting a permit willquth6rize4the permit'holder'to;b'uild 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 Wfull coneurrency review:.room•additi(ins, 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�th"e first inspection."lf you intend.to obtain financing, :consult with lender K an attornev before commencing work or'recording your Notice of Commencement. Signat a of ontractor - or - Owner Builder as applicable STAT LORID ' COUNTY OF Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization this day of , 20_ by Name of per n making statement. Personally Known OR Produced Identification Type of Ide tification Produced (S•ignatur o No ary Public- State of FI ida) Commission No. (Seal)? , �r"".'''•% LASHAHNAINGP,A.M•RAHMiIh : j COMMISSION # GG 27WQ EXPIRES: Cereml'Ar 7.u,'LD22; Bonda�l Thin Nn iy : •;},�,u Und�awri ars REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER . REVIEW..., REVIEW REVIEW REVIEW. REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 10/12/21