HomeMy WebLinkAboutPERMIT APPLICATION_5210 HICKORY DRIVE_SCARPETTI RESIDENCEAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
dLRI0C[IL� rti
6 ° Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMITAPPLICATION FOR:J a•
� i 1Fi
Address: I D 14; C rr) p rrJ0 47L H Cl q<R� ?.
Property Tax ID #: ;2 - ( Lot No. I- I
Site Plan Name: Block No. c�
Project Name:
DETAPLMD DESCRhPTIt3,Ni
New Electrical Meter Second Electrical Meter
;Ca;�4STR? 1CT{QJN' P -O tM Tv,,ION
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors Pond
_ Electric —Plumbing —Sprinklers _ Generator ` Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of Construction: $ 10� Utilities: _ Sewer _ Septic
Building Height:
41f�/N'E,R'/L` ESS'E€ - --
CO,I'TRAYCTOR'
NameM,,*'_kn'0 t "5r.0.vPL_-I-I'i
Address: �7�11� i� ►LYS rpt �,/ a'
Name:, ia- k <n -2'n
Company:—, L
Address:-
City: State:CL
ZipCode: _ �� Fax:
City:it State:FL
Phone No.
Zip Code: Fax:
E -Mail:
Phone No
Fill in fee simple Title Holder on next page { if different
E -Mail ) Y/-4�
from the Owner listed above)
State or CountyLicense
++ vamu Ur avnszru" ons eovu or more, a KC1.UKUCU Notice or commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION -LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
dame:
Address:
Address:
City:.
City:
Zip: Phone:
Zip: Phone:
OWNERI 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 apermit 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 accessory 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencinea work or recordine vour Notice of Commencement_
l
Signature f Owner/ Less /Contractor as Agent for Owner
Signature of Cntractor/Lice a Holder
STATE OF FLORIDA
STATE OF FLOR ®A
COUNTYOF 5T LGc e �"
COUNTY ®F 7i /.�tI�
The forgging instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of J u ki-e 120 ZG by
this LIT4 day of 20Z0 by
erson making statement
of person making statement
Personally Known OR Produced identification
Personall n - OR Produced Identification
fTdentification
Type of Identification
Produced
P
Produced
(Signature ary i - tate �f r��iq�b
,,! ota u tate of Florida
(Sig tore of Notary P b'
ry
=o1PnY
a Joshua yshane. Alberico
alParaOB� Notary Public State of Florida
Commission o. Mie Gvmsr3GG 020879
Commission No_ : Joshua S(-@i�lberico
'FOF eL°� Expires tl8/1G/2020
`? ep My Commission GG 020879
Expires
Opt 08/16/2020
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2117