HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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n I Building Permit Application
Planning and Development Services
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�Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue,Fort Pierce FL 34982
I Phone: (772)462-1553 Fax: (7172)462-1578 CBDG Funding
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PERMIT APPLICATION FOR
ON
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1 Lot No. I
Property Tax ID#:
Site Plan Name: I,I Block No. -
Project Name I {
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New Electrical, er I Second Electrical Meter (Affidavit'required)
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`Additional work to be performe i under this permit—check all that apply: •
Mechanical Gas Ta I k _ -Gas Piping —Shutters T Windows/Doors _Pond
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_Electric _Plumb,,ling —Sprinklers —Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of.Construction: $ \� �n Utilities: —Sewer —Septic—-__Building Height:
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Name C`� ° �-w'�
Name:
Address: �—k,( Company:
Ciiy: fi �1 � `State: Address:
Zip Code:��c4-1 Lf Fax: City: State:
Phone No. (p E- Zip Code: Fax:
Mail: Vl\
Phone No
Fill in fee simple Title Holder on next page (if different E-Mail
from the Owner listed above) Ili i State or County License
6
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
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If value of HAVC is$7,500 or more,la 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 our Notice of Commencement.
nat e of Contractor-or- caner Builder as applicable
STATE OF FLORIDA
COUNTY OF
Sworn to�oJ.�firmed)and Abed before me of ��ysi�6a—lPres�ence or Online Notarization
this_ iZ&y of 2 q
Name of person making statement.
Personally Known OR Prod uc ntifi ation
Type of Identific ti n Produced_
(Signature of Netary Public-State of Florida)
Commission No. (Seal)
Y P�, ELLEN VAUGHN
"'pYl e', state of Florida-Notary Public
_* *_ Commission # GG 270079
_y _ a
eteber 22 2022
REVIEWS -._, _ 5 R PLANS, -VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW • REVIEW REVIEW REVIEW
DATE
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COMPLETED
Rev 0 2 21