HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Building Permit Application st. Lucie
Counry
Planning and Development Services Permitting
/
Building and Code Regulation Division Commercial Residential V
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: 1 ad�
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Property Tax ID #: tE�O'o Lot No.�
Site Plan Name: 10.
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Project Name:
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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 JZRoof Pitch
Total Sq. Ft of Construction: t Sq. Ft. of First Floor:
Cost of Construction: $ -7 Utilities: —Sewer _ Septic Building Height:
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Name �„Yrl
Name:a
Company: - C2
Address: �Oc ` e4 .c a=j!� c��,
Address: l Zzi
City: (2Z� State: %AL
Zip Code: "Z'7 l Fax:
City: Stater
Phone No. E-
Zip Code:�Ct�l'1% . Fax:
Mail:
Phone No_ 7_17 .— 2--
Fill in fee simple Title Holder on next page (if different
E-Mail -<�;' c, %
State or County License (�s_-G t__711
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.
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DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE
COMPANY:
Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City: State:
Zip:
Phone
Zip:
Phone:
FEE SIMPLE TITLE
HOLDER:
_ Not Applicable
BONDING COMPANY:
Not Applicable
Name:
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 attorney before commencing work or recording your Notice of Commencement.
Signature of ntractor - or - wner Builder s applicable
STATE OF FLORIDA
COUNTY OF
SworAto (or affirmed) and subscribed before me of
P�h Presence or Online Notarization
this day of - 20ZZby
Name of person making statement.
Personally Knowny OR Produced Identification
Type of Identification Produced
(Signature of Notary Public- Stap4 of Florida)
Commission No. Seal
(Sea])
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REVIEWS FRONT ZONING SUPERVISOR
PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW
REVIEW REV':EW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED