HomeMy WebLinkAboutBldg Permit AppAll APPLICABLE/INFO /MUSTBE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 / o Permit Number:
nnIb
9 lr L O�
M° 'Q( °
', Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial 1' Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED
IMPROVEMENT
LOCATION:
Address: R 0 1Aryv �j 60 R
jot',/
Property Tax ID#::9�q 5" ?ol003)—Ooo'. Lot No.
(
Site Plan Name: l/R(olAr cote f 104 d L444erLczoct ✓ec( Block No.
Project Name:HOe oAr Plkg� e Lakeo'pf e 4c¢iy,1y Cc,, we - 4Se J.
DETAILED
DESCRIPTION
OF WORK:
Add i t 1'0" r`C kle boll f fernove4l t ra l erm ee�
� ✓kr'n 04� l� I'rlOtd�7r'CG�>t,Yi6'I �C r`e1®cct�1� �-t'lI�-�
war J r�erna
orre S�rIXc +arr-
rrd
New Electrical Meter V Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
.Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Pond
V Electric V�Flumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Al Q lIYIAClIAV(� Sq. Ft. of First Floor: AV-1
lI p
Cost of Construction: $ (On d.00/ Utilities: ZSewer _Septic Building Height:1i/IA_
OWNERAESSEE: AfSpG�Gfl�r
CONTRACTOR:
Name /Jarbaur AdAf r p*4�1 j2tnnefS L
Name: m ge c 6i o fd (" Ales I
Company: GCtrM Corr SM4t41 ah L BAIL'
Address: 6, s:13500NW OLok'l �
City: a_I tyx C 11t z // State: FL
Zip Code: 311a R ,� Fax: ??P 33
q
Address: f ?� t ? J7hd16a0 R,"vK Elva Lag /t
City: V erfl S eacA State: FL
Phone No.? Z2 336 SR 08
11 77
Zip Code: q K6 Fax: T T� ��0' 364
E-Mail: ,iRlCrYaenrL4 r CC, f
�
Phone No �'"zZp 307}
Fill in fee simple Title Holder on next page if different
from the Owner listed above)
E-Mail Vv ; k E' CO
%r � h COn �friAtf iyt ?, LOvh
State or County License Un C (5 } 6 q 3
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
Name: e50Af(0e5r'ciri
Address: 30 I uoiti✓ Pa(,kCir # 10)
City: To ( er State: P`
Zip: 33q"5S Phone 5(b a03 750
FEE SIMPLE TITLE HOLDER: _Not Applicable
Name: Same QS oWne✓ on previous ®7,d17
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:,
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:_
Not Applicable
Applicable
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 Countyy 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 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 your Notice of Commencement.
a (on ivac¢OrGS/�Cyerat
�
Signature of Owner/ Lessee/Contractor as Agent for(Owner
. Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA_®
ry
COUNTY OF :r1t)attrt R a V ler
COUNTY OF .Ze'Vk&41 Pe VCf'
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Z Physical Presence or Online Notarization
this f!8 day of JU,LV 2020 by
this jla day of Jgz,V 2020 by
&I1 2Z= />! /ry
,t7II%Jlna� OAlell L.
Name of person making statement.
Name of person making statement.
Personally Known ✓ OR Produced Identification
Personally Known ✓ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
/
(Signature of Notary Public
gnature of Notary Public-
MpRI0NH.7UNEK
;,.a;�:,: MARION H. iUPEK
Commission No
QQ
( Sal OMMISSION#FF 973380
�b1Y MMISSION#FF 973380
iNi.
` t<XPIRES: July 21,2920
C
mission No.
('C$J�IRES: Juy21, 201.0
Sondod 71xu Notary Fublk Undernri
ors
F Sonded'mru Notary Public Undenvd
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20