HomeMy WebLinkAboutBuilding PermitAIR APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO HE ACCEPTED
Date: Permit Number:
®}.
Dr E c �� ° En, Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce F,, 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 29 LAKE VISTA TRL 105
Property Tax ID #: 3422-500-0397-000-9
Site Plan Name:
Project !Name:
DETAILED DESCRIPTION OF WORK:
REPLACEMENT OF 28 GAL ELECTRIC WATER HEATER
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Lot No.
Block No.
Additional work to be performed under this permit– check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors _ Pond
— Electric V Plumbing _ Sprinklers _ Generator hoof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 1,200 Utilities: —Sewer _Septic
Building Height:
OWNERAESSEE:
CONTRACTOR:
NameRUSSEL COHEN
Name:STOYAN STOYANOV
Address: 3690 SW RIVERA ST
Company: EUROELIT INC
City: PORT ST LUCIE State: FL
Zip Code: 34953 Fax:
Phone No.
Add re ss: 6129 NW DROPHY AVE
City: PORT ST LUCIE State:�
Zip Code: 34986 Fax:
Phone No 772-777-0010
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail EUROELITINC@YAHOO_COM
State or County License CFC1429089
.. rwl— - 4VIiaUuL LIU11 M 4Z1VU UI 1fluie, d nrl-wnuru iVotfce o7 commencement is requirect.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESI&ERjENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: — Not Applicable
Name:
Address:
City:
BONDING COMPANY: Not Applicable
Larne:
Address:
City:
Zip: Phone:
Zip: Phone:
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 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 borne 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 a, or�ey before commencing work or recording yours tijpe of Commencement.
Signature of OwnerfLessee/Contractor as Agent for Owner I Signature of Contr or/License Holder
STATE OF FLORIDA' STATE OF FLORIDA
COUNTY OF COUNTY OF
Swor to for affirmed) and subscribed before me of Swo r].to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization .✓Physical Presence r Online. Notarization
this day of A`� \ 1020 by this _. � day of _ .3v���r 2020 by
Name of person making statement. Name of person making statement.
Personally Known V OR Produced Identification
Type of Identification
Produced .. /
Erik Nemoga
Commission No. Tiialon # �GG101442
(elres: May 4, 2021
Bonded tllrl! Aaron Notary
Personally Known :/ OR Produced Identification
Type of identification
Produced
Cj5ignature-oFNs c-Public-Statetir4 ;jda) ErikNemoga
o... mission # GG101
Commission No_ �{n
"sA expires: May 4, 2(Y
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE - -- - --
DECEIVED
DATE
COMPLETED I