HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLIC L iE I FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 - Da a
Planning and Development Services
RECEIVED Permit Number:
MAR 0 202z
Bt. �01@ County
'Wirmit Application
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED --IMPROVEMENT LOCATION: me
Address:
Property Tax ID#:_0(DLf �a oC I
Site Plan Name: Urmt %10 p1��
Project Name: Iv-r-r,,�
DETAILED DESCRIPTION OF WORK:
Residential
New Electrical Meter Second Electrical Meter
(Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed
_,Mechanical
under this permit - check all that apply:-
_ Gas Tank _ Gas Piping
— Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Constructions $ f0l—I Alia0
Lot No. 1
A)ock No. c�
— Shutters _ Windo s/Doors _ Pond
_Generator Roof �`® 12- Pitch
Sq. Ft, of First Floor:
/D 0 Utilities: _Sewer _ Septic
OWNER/LESSEE:
('� CONTRACTOR:
Name �J �ilr'l� IZ!'
Address: k4 rr
City: �� �� �; Stater
Zip Coder Fax:
Phone No. - -
Mail: n i'at✓1 E-
:ill in fee simple Title Holder on next page (if different
:rom the Owner listed above)
me:
Building Height:
-State:
Zip Code: 3 LC I _ Fax:
Phone No7� ! q
E-Mail i-A d��
State or County License'
f value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
`value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
Z.ompany:
Address;
City:
11!It'IV;.IHL-_CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGI '
Name; NEER: — Not Applicable
Address;
City:
Zip: Phone State:
FEE SIMPLE TITLE HOLDER:
Name: Not Applicable
Address:
City:
Zip: Phone:
MORTGAGE COMPANY; Name: Not Applicable
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 installation has commenced prior to the issuance of a permit.
w Lucie County makes no representation that is granting a permit will authorize the permit holder to build the sub'
which conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit
structure. Please consult with your Homeowners Association and review your deed for any restrictions which may apply,
sect structure
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the such
in accordance with the a y
approved plans, the Florida Building Codes and St. Lucie County Amendments, work
The following building permit applications are exempt from undergoing a full concurrency review: room addition
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failur6. to Record a Notice of Commencement may result in s, e
improvements to your property. A Notice Of Commencement must be recorded in the
Lucie County and posted on the jobsite before the first inspection. If you intend to Ing twice for
with lender or an attorneybefore commencin work or recording our Notice of oom public records of St.
obtain financing, consult
t.:..®�� Commencement.
Signature of ner/
as Agent for Owner
STATE OF FLORI
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
this day of 2027by Physical Presence or Online Notarization
wurne or person Maki statement.
Personally Known OR Produced Identification
TypeAldentification Produced E
%snaZure or (votary Public- State of Florida)
Commission No.(Seal) DENISE ELAINE SOAR!
o��err�e•
;+ Notary Public -State of Flori
Commission # HH 52997
'••:,A`' MY Commission
October 13, 2024 Expires
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