HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICA LE 1 FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
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PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 8242 Martingale Ln
Legal Description:
Port St. Lucie. FL 34986
Property Tax ID #: 3M- ini- n4- oop- Q Lot No.(C��
Site Plan Name: Block No.
Project Name: 111,1119. `("��W D-Y'
Setbacks Front Ls Back: 14 Right Side: Left Side: rg -F1
DETAILED DESCRIPTION OF WORK: III
CONSTRUCTION INFORMATION:
�Cddrtlona wow two nee pe—fr ormed under this permit -check all that apply:
_HVAC _Gas Tank _Gas Piping _Shutters —Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator _ Roof = Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ / n
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name lker Leycegu,
Name:
Address: 8242 Martingale Ln
Company: Tesla Energy Operations, Inc.
City: Port St. Lucie State: FL
Zip Code: 34986 Fax:
Phone No.7723322444
Address: 8500 Parkline Blvd. Ste 100
City: Orlando State: FL
Zip Code: 32809 Fax:
Phone No.41-111
E-Mail: iker.leycegui.md@protonmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: )� I (a Wo a( CQA +.e(f
State or County License: C13006226
It value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION= LIEN LAW INFORMATION,,
DESIGNER/ENGINEER:
Name: A)i ((LLS GnrGlc3»
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: 8 /c_� R/._.
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Address:
City: Oip
Zip: 3g 3S27 Phone Yo y-C19
State:Fe
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City: State: .
Zip: Phone:
FEE SIMPLE TITLEHOLDER:
Name:
_ Not Applicable
BONDING COMPANY: _Not Applicable
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 is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners 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 accessary uses to another non-residential use
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE)IEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN NCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE ObCOMMENC ENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF jorall
COUNTY OF
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REVIEWS
FRONT
ZONING
S
PLANS
VEGETATION
SEA TURTLE
MAN
RC9VFs0
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
RE
DATE
RECEIVED
DATE
COMPLETED
Rev. 2///19