HomeMy WebLinkAboutPermit ApplicationAIIAPPL]CABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:6t2312020 Permit Number:
Building Permit Application
P I onn i n g ancl Dev elop ment Se rv ice s
BuildinlT ond Code Regulotion Division
2300 Virginio Avenue, Fort Pierce FL 34982
Phone: (77,1\ 462'1'553 Fax: (7721462'1578
Commercial Residentia I
Property Tax lD #:
Site Plan Narne:
34it6-500-0361-000-0 Lot No. 25
g1o.1 11s. 1 &2
Prolect lrlame: Lombiardo Residence
@tifr ilpii'or,r or wonr<,
lnsiall 50amrr Generator inlet and Interlock Kit in the Garage
New Electric,al Meter Second Electrical Meter
Additionalr,Vork to be performed under this permit - check all that apply:
-Mechanical -
Gas Tank
-
Gas Piplng
-
Shutters Windows/Doors
-
Pond
_ Roof _ PitchE ectric _ Plumbing -
SPrinklers _ Generator
Sq. Ft. of First Floor:Total Sq. Ft of Construction:
Cost of Construction, S a1! !9 Utilities:
-Sewer -SePtic
Building Height:
owNlER/'LESSEE:
Ssms Matthew Josr:Ph Lombardo Name: Kent Blosser
Company; Blosser Electric
State:Address: PO Box 7305
i zlp cud., 34952 Fa x:City: Port Saint Lucie 5tate: ''
phone No. 914-804-2915 ZiP Code: 34985 Fax:
E-1y 3 ; 1. Ther 1 1 Bear (lv erizon. net phone pe 772-337-0055
Fill in fee simple Title Holder on next paCe ( if different E-Mail nrblosser@gmail.com
from the Owner listed above)State or Countv 1i6gn5s EC1300'l 570
lf value of construction is 2500 or more, a RECORDED Notice of Commencement is required'
lf value of HIiVC is S7,!;OO or more, a RECORDED Notice of Commencerment is required.
PERtvl lT ltPPLlCAT|oN FoR: glgCtfiCal
PROPOSE:D I M PIiOVEM ENT LOCATIO N :
Address: 25 Florida W"y, P94 Jq,n!!y!'"
@'t-t,q"6lrylgB 9S
CONTRACTOR:
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
MORTGAGE COMPANY: Not Aoplicable
Name:
State:
DESIGNE
Name:
_ Not Applicable
Address:
FEE SIMPTE TITLE
Name:
State:
Phone
HOLDER:_ Not Applicable BONDING COMPANY:
Name:
_Not Applicable
Address:Add ress:
City:
Zip: _ Phone:
OWNER/ CONTRACTOR AFFIDVIT: Rpplication 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 Countv makes no representation that is granting a permit will authorize the permit holder to build the subiect structure
which is in conflict with anV applicable Home Owiers AsSociation rules, bvlaws or and covenants that mav restrict dr prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions ltihich 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 5t. 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 T'O OWNER:Y/ur failure to Record a Notice of Commencement may result in paying twice for
improvements to yolr property, A Notice of Commencement must be recorded in the public records of St.
Lucie County andposted on the jobsite before the first inspection. lf ygu intend to obtqin financing, consult
witfr lender or arf attornev beforeSommencing work or recording vour Notice oJ Comnp(encement.,tI '
Signature of Owner/ Less6e/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
\.ZPhvsical Presence or Online Notarizatronthffii ory or r)r^n- ,2020 by
,/
Personallv Known \/ OR Produced ldentification
Type of ldentification
Produced
(Signature
Commission No.
REVIEWS
DATE
RECEIVED
DATE
COMPLETET)
Name of per:;on making statement.
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
Name of pe making statement.
Produced
(Signature of Notary
Commission No,
,a
Personally Known V OR Produced ldentificatjon
Type of ldentification
Sworn to (or affirmed) and subscribed before me of
-;2(ehystcal Presenqe or
-
Online Notarization
ir: Mr uuMMtsstoN # GG 970043
EXfffi.iMarch 16,202a
eq$gf fi 'ru- Nd/ary puMc Unde,x,rirers
FRONT
COUNTER
ZONING
REVIEW
SU PERVISOR
REVIEW
PLANS
REVIEW
SEA TURTLE
REVIEW
VEGETATION
REVIEW
MANGROVE
REVIEW