HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: U/ /! 12 - V Permit Number:
BuildingApplicationPermit
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
PERMIT APPLICATION FOR: PLUM(6'iNU
PROPOSED IMPROVEMENT LOCATION:
Address: 95S�
�
S P Ar%J a� 4�I�
Name: DG1Vid e, U��.
Q-�
Property Tax ID #:
-3
oz=� -- 5) 0 2 '
o C),4,:7 "
0 00 Lot No. 3 V
Site Plan Name: Block No.
Project Name: W o o r-4 A �
DETAILED DESCRIPTION OF WORK:
50ft9allo✓)
9 Yl S`TA I l e teuty-1 C. Ini A+ e r' �n e Ct1f V'
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
Mechanical
Electric
Gas Tank
Plumbing
Gas Piping
Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 3 2 �3 C1 • 0
(0
Shutters Windows/Doors Pond
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name C "f- oanon
Name: DG1Vid e, U��.
Address:5 525 �961Aael Y e.,v-
Company: MeCK •_ SOVIS Plun)bmo v it1C
City: l� 1 ���� State: �
Address: � (0 � �' '��C%, ��y-i-U( �Y'
Zip Code: v�'i � 5 Fax:
City: as"$1 GpY1, State:
Phone No.
Zip Code: 32CjQj Fax: -17? • S9jl 7.0 � 11
E-mail:
Phone No T1 2 • 2-0 f�o
Fill in fee simple Title Holder on next page (if different
E -Mai I �A,, (L C- E4- S C)NS PL, LA Nj 6 t bJL,14 (0 G M A ! L. (a0J
from the Owner listed above)
State or County License C� F*Co 0 q _1 3_1 L/)
IT value or construction is 15uu or more, a KELUKDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: RNiATI�N:
NER%ENGINEER: Not A lic
Name: pP able MORT�AQf COMPANY: Not Applicable
Address: Name:
City: Address:
Zip: Phone --State: City:
� Zip. State:
Phone.
FEE SIMPLE TITLE HOLDER;
Name: :.._ Not Applicable BONDING COMPANY: AIVY: Not Applicable
Address. Name.
City: Address:
Zip: Phone: City:
Zip: Phone:
OWNER/
CONTRACTOR aFFIDVIT: - -
lcertify that no work or installation Application is hereby made to obtain a permit to do
n has commenced prior to the issuance of apermit.the work and installation as indicated.
whichCount makes no representation that
ch is in convict with an is granting a pptrrnit will a •
PFlicable Home Owners Association rules authorize a the cove holder to build the subject p
structure. Please consult vuit� your }come .. bylaws or an� � structure
Owners Association and review your deed for covenants that may restrict or prohibit such
In consideration of the granting of this requested y restrictions which may apply.
to accordance with the approved plans, eq d permit I do hereby agree that I will, in all respects,
Florida Building Codes and St. Lucie County Amendments.
perform the work
The following building permit applications areants.
accessory structures, swimrnin exempt from undergoing a full concurrency review: roomadditions..
� pools, fences, walls, signs, screen roams and accessory add,t�ons,
WARNING TO OWNER: Your failurery uses to another non-residential use
improvements to yourproperty. to Record a Notice of Comrrtencement rrga re
i.ucie �ottnfY: and o A Notice of Commencerrien�k ,, � y soft in paying twice for
wit�rie Posted on the jobs a ,4efore the first ' .- t be recorded in the public record
oder or a�ftorne before lnspe4'tion. if yo�t ,Mend to obi ' sof 5t'
:� ,�aenc�n work or reE4rdiri o , , to fi arcing, consult
r jf f, ur, filatice of Ca mea ement.
////
Signature of Own -- ,
er LesseeJC'antractor asAgentfor Owner Signature of contractor/License STATE OF FL icense Holder
COU �'� •
NTY o F � STATE OF FLQWA
COUNTY OF i
Sworn to (or affirm �d) and subscribed before me
Ph 'cal Preset a or of Swor to dor affirmed
this „,M,•, V of Online Notarization � } and subscribed before me of
2020 by Ph rcal Presence r Online Notarization
this y of 2024
by
Name of person making statement. ?s n - tM-eels.
Name of person making statement.
Personally known
-- 4R Produced Identification „�_
Type of Identification Personally Known
P doted OR Produced identification
TY of Identification
P uced
(Signature cf Notary public -
State of Florida �
Commission IUo. ��Y �`�� CATHERINE A`NHEEL R� �8riature of Notary Public• State of Florida
# .n al Comr�tssion GG 305 5 ,,� YFU%,CATHERINEA WHEELER
CO, 4 's June 3 202 omrr►ission No. 3�:>3
s �o E r . ,{ misolon # GG
F` BU,: �17Wu 8odgetNotary 6 � � giros June 3, 2823
REVIEWS FROIUT oF�� �aear�wsso�ry
COUNT ZONING SUPERVISOR p
ER REVIEW REVIEW PLANS VEGETATION SEA
BATE REVIEW REV! TURTLE MANGROVE
RECEIVED REVIEW REVIEW REVIEW
DATE
COMPLETED
ev.