HomeMy WebLinkAboutapplicationAll APPLICABLE INFO MuST BE COMP
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F ® R B A
Plann.Ing and Development Services
Building and Code Regulation Divis.Ion
2300 Vjrg.In.ia Avenue, Fort Pierce FL 34982
ED FOR APPLICATION TO BE ACCEPTED
Permit Number:
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Building Permit Application
Commercial
Phone: (772)462-1553 Fax: (772)462-1578 CBDG Funding
Residential
Property Tax ID
Site Plan Name:
Project Name:
Block No.
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION ]NFORMATloN
Additional work to be performed under this permit -check all that apply:
Mechanical Gas Tank Gas piping
Electric plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: S
Shutters Wi ndows/Doors Pond
Gen erato r Roof
Sq. Ft. of First Floor:
Utilities: Sewer _ Septic Building Height:
OWNER/LESSEE:CONTRACTOR:
Fill in fee simple Title Holder on next page (if diffel.ent
from the Owner listed above)
Company:
Address:
Zip Code:
Phone No
E-Mail
State or County License
If value of constructlon ls 2500 ar more, a RECOF`DED Notice Of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Nctlce Of Commencement i§ required..
SU'PPLEM.ENTAL toNSTRUCTl.0,N L[ EN LAW I NFORMATiord:
I
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable I
Name:Name:
Address:Address: \ i\
City : State:City: \ !\ State:
zip: phone \ rr`\\\\\,zip: phoK: \\ \u!ck~
LEaEms:prpLETITLEHOLDN\+Nftplicable R:#e?`NG C°MPANY\ N uNo\Applicable
Address: \ - I 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 indicat d.
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.rw#tfhref€§EBeFnvota§n:d£REttu#nffEEbete#Svj]eoAbcsg.o#£beeesoo{rfegot#we#k%r=nfep%t#d
%#yeoLejcn::dneddt:notSteapnuf?LjingyourNoticeOfCommence
c records of St.ancing,consultment.
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Signature oi CoVIractor -ob -Owner Builder as applicable
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:hTsofftdoaryaofff,r#F¢:,#u#ffbe:2b€#:ffiof hys,Ca, Presence or_on„ne Notar[zat,on/__'`
Name of person making statement.
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATERECEIVED
DATECOMPLFTED
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