HomeMy WebLinkAboutPermit Application (1)All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number.
1, LLcCEwit
d
Building pp 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
PERMIT APPLICATION FOR: 60roIC poor
PROPOSED IMPROVEMENT LOCATION:
Address: yglo sunset Blvd
Property Tax ID a: 3L102 - IOOg- 02y3- ODO-y Lot No.—O--
Site Plan Name: 1 ICI{1_ P-%VCr_ ES` 6t'C S - Urj-f 0-I Block No. Y-7_
Project Name:
DETAILED DESCRIPTION OF WORK:
—C, 0MC door
New Electrical Meter 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
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR: `
Name p<Itintref- Inv-CStmfnt LLC,
Name: ISSOC bQrI0
Address:SyOI C>,tY[AS AvG-
City; FOY} n►erCC stater
Zip Code: 3L4CIY2 Fax:
Phone No. --I 7 2- 370-333y
E-MaiI:K0KOPPQImtyCC@pyl}-Y7i I.(0rO
Fill in fee simple Title Holder on next page ( If different
from the Owner listed above)
Company: A TI:eh &Gtrnac ux)o(s
Address:7. G-pFprfih f3 Vd
City: Port S- Lu(- c, State: FL
Zip Code:3y 252 Fax:
Phone No 1-12' 2Y-S411
E-Mail 0fCCh 9QrQgCdCCr G]n-Q i I C O r"
State or County License
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.
T
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
Address:
City: � State: T
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:_
Not Applicable
State:
BONDING COMPANY: ,Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated_
E 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 an 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 attornev before commencing work or recording your Notice of Commencement.
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA -
STATE OF FLORIDA
COUNTY OF `lam- l
COUNTY OF
S orn to (or affirmed} and subscribed before me of
5w rn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
hyslcal Presence or Online Notarization
this j� day of ��� 2020 by
this 4 � day of Sv`�` 2020 by
Name of person making statement.
Name of person making statement.
0�1'
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Ty p of identification
Type 9f Identification
Pr uced
Prod ed
^�
Signature of Notary P a NOT Y LfG
(ignature of Nota
a S STATE O RIDA
Commission No.
ARY PUBLI�
Commission No. a P=_�7:AE OF FL
orrxr�# G14
Expires 2/1412022
TwGG18 914
19}Ex ires 2/14/2022
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/5/20