HomeMy WebLinkAboutScan_20220315.pdfAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Building Permit Application
Planning and Development Services
Building and Cade Regulation Division
2300 Virginia Avenue, Fort Pierce Ft 34952
Phone, (772) 462-1553 Fax: (772) 452-1578
PERMIT APPLICATION FOR:
Commercial
CBDG Funding
PROPOSED IMPROVEMENT LOCATION:
Address: 1 �� �ICi21��R. �►CIa�" t�7'
Property Tax I D #: '4 L-1 �.n - 9nk �-*, -�
Residential
Lot No.
Site Plan Name: Block o.
Project Name:
DETAILED DESCRIPTION OF WORK:
-"Ek
New electrical Meter
�u
Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
Mechanical has Tank ,Gas Piping _Shutters
electric
Plumbing
Total Sq. Ft of Construction:
Cost of Construction: au C�
OWNER/LESSEE:
Name
Sprinklers
(Affidavit required)
Generator
q. Ft. of First Floor:
Windows/Doors
Roof
Utilities- _Sewer � Septic Building Height:
Address. _
i t : - State: V L,.
Zip Code: Fax:
y
P h o n e N o. L p kb OLVI'm)
Mail.
Fill in
fee
simple
Title Holder on next page cif different
from
the
Owner
listed above)
E_
CONTRACTOR:
Dame:
Company: _ _�a Nk'C- Cn
Address:
city:,;
i
ZipU Fax:
Phone No
E- a i l
State or County License VP
If value of construction 'I's 2500or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more., a RECORDED Notice of Commencement is required.
Pond
Pith
r State,,
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
,� Not Applicable
Name:
Address.
City; State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: - Not Applicable
Name:
Address.
City:
Zip* Phone:
MORTGAGE COMPANY: Not Applicable
Name.
Address:
City: State:
Zip: Phone..
BONDING COMPANY:
Name:
Address.
City:
i Phone:
_,ANot Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated-
! certify that no work or installation has commenced prior to the issuance of a permit.
5t. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which conflicts with arey applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit suchstructure. 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 concurrent 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