HomeMy WebLinkAboutmarchellettaAll APPLICABLE INFO MUST BE OMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
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D I ng a I B a -~~
Planning and Development Services
Bu.IIding and Code Regulation Divis`ion
Building Permit Application
Commercial
2300 Vjrg.In.Ia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 CBDG Funding
Residential
Project Name:
New Electrical Meter Second Electrical Meter (Affidavit required)
coNSTRucTION INFORMATroN :
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 Windows/Doors Pond
Generator Roof
Sq. Ft. of First Floor:
Utilities: Sewer _ Septic Building Height:
OWNER/LESSEE:CO NTRACTO R: I
Name
Phone No. 73
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Company:
Address:
Zip Code:
Phone No
E-Mail
State or County License
If value of construction ls 2500 or more, a RECORDED Notice of Commencement ls required.
If value of HAVC is $7,500 or more, a RECORDED Nctlce Of Commencement i§ required..
ISU'PPLEMENTAL CONST RucTroN LIEN LAW IN'FORMATION:
DESIGNER/EN GINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name:Name:
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City:Ci.
Zip: Phone:Zip: Phone:
OWNER/ CONT RACTOR AFF lDVIT: Applic ation is hereby made to obtain a permit to do the work and installa tion as indica ed.Stult
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 thainaccordancewiththeapprovedplans,theFloridaBuildingCodesandSt.Luciet I will, ln all respects, perform the workCountyAmendments`
The following building permit app ications 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 ln paying twice for
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c records oancing,conment'
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Signature of CoVIractor -o€ -Owner Builder as applicable
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Name of person m=Hing statement.
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TU RTLE MANGROV E
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATERECEIVED
DATECOMPLETED
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