HomeMy WebLinkAbout5782 Clydesdale Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: .. ..
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Plannngiand Development Services
Building and Code Regulation Division
Hermit Number:
2300 Virginia Avenue, Fort Pierce FL 349,82
Phone: (772) 462-1553 Fax,: (772) 462-1578
Commercial
PERMIT APPL
ICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
or
Address: LD
7W.PW - i I � -(J C r -f/7
Property Tax ID #:
Site Plan Name:
Project
Name:
0
av
New Electrical Meter Second Elec
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters
Residential \>100
4F
Windows/Doo
rs
_
E�C��� i
Lot No. C;-��
Block No. 7`i
c _ Plumbing _ Sprinklers _Venerator � Roof
Total Sq. Ft of Construction: _ >wm G�sS - Sq. Ft. of First Floor:mo
`
f 5l0 Sys.
Cost of Construction: $ Utilities: _Sewer _Septic Building Heigh
Name �
A d,d,.r e. ss:
ci Y� t")i� t
Phone No.
E -Mail: ( 1
Fax:
Pitch
Name
Company:
State Law,
Fill in fee simple Title Holder on next page
from the Owner listed above)
(if different
Address:
G Ty��
Zip Co
Phone
E -Mail
State c
State,��
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
MEEEEEEEEERIM� N o t A P P I i c a b I e
Address:
City: State:
zip: Phone
FEE SIMPLE TITLE HOLDER: � Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
ZIP11 Phone:
OWNER/ CONTRACTOR AFFIDVIT-6 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 marestrict or prohibit such
structure. Please consult with your Home Owners Associatiy
on 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 andSt. 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 anoth"er non-residential use
WARNING TO OWNER*. Your failure to Record a Notice of Commencement may result in paying twice for
improvements #a your property. A Notice o T I ommencement must be rpr-orripri in t
Lucie County and posted on the
with lender or an attorne
jobsit
he public records of St.
e oeTore the first inspection. If you intend tn obtain financing, consult
before LUFTIMencin
<4 C
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA L � L �
COUNTY OF
`worn to (or affirmed)and subscribed before me of
Physical Presence or Online Notarization
this ��d a y o f `�`� +? , 2020 by
Name of person making statement.
Personally Known .� OR Produced Identification
Type of Identification
Produced
(Sign
re of Notary P,
Commission No.
REVIEWS
- fij
Notary f Fic6de
r _ f%W
My Commission GG 240M
Expres 07122/20,22
FRONT
COUNTER
ZONING
REVIEW
worK or recorciing Vour Notice of Commencement
M
SUPERVISOR
REVIEW
Signature of Contractor/License Holder
STATE OF FLORIDA 1.41
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Ph, ysical Presence r Online Notarization
this day of ' I , 2 020 by
f <
Name of person makin 'statement.
Personally Known��` OR Produced Identification
ON --- MENNEMIEM
Type of Identification
Produced, /7
ffj7,'nako0ur'F10f Notary P�
Commission No.
PLANS
REVIEW
VEGETATION
REVIEW
Notary Public
,00 at 7FL 77aD e -cs 1 reei
M ;Omni -ion G 240M
Exp res 07/22/2022
w
s
SEA TURTLE
REVIEW
MANGROVE
REVIEW