HomeMy WebLinkAboutlarry gerardi bldg appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -7 2-0
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential .X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: z '�C J G (-c ,/ 0C fl i,, er (. t- F' L I
Property Tax ID #: _ 2--4 2-0— 2 i O - - 000 - 1 Lot No.
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
_ l( 3j ) in �'l 'l ce tf 1 l vp
oo plumbing G n10 drive 1N C�
New Electrical Meter
Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit - check all that apply:
Block No.
Mechanical _ Gas Tank Gas Piping _ Shutters _ Windows/Doors _ Pond
Electric _ Plumbing _ Sprinklers — Generator — Roof Pitch
Total Sq. Ft of Construction: t CeQ
Cost of Construction: $ l V q2_
Sq. Ft. of First Floor: (c)5
Utilities: _ Sewer q Septic Building Height:
OWNER/LESSEE: I CONTRACTOR:
Name
Address: C-qJt- Clz
City: F+ P, r C State: FL
Zip Code: 1�( I Fax:
Phone No. `x,l - pis i-,' l
E -Mail: CIric-,KCC i']ilkz)(MAiIiC'-c-1M
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: ZAM&'PL_) t:
Company: Cowpo - t�ntau•� 2
Address: PO -7 (,? JS -
City: `a T'Ar' ke State: L
Zip Code: Fax:
Phone No '��
E -Mail 7 ori 5 o urea,
State or County License O QC I
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.
V-�J
SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION:
DESIGNER,/ENGINEER: Not Applicable
MORTWWE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
Personally Known OR Produced Identification
City
Zip: Phone:
Zip: Phone:
OWNER,/ CONTRACtOR AFFIDVIT: Appiication 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. Jude County makes no representation tha=1snting, apermit will authorize the permit holder to build the subject structure
which is In conflict withanY ticable Nome Assodation rules, bylaws yr and is that may restrict or pr habit such
structure. Please eonsuit wimp our Home Owners Association review r deem far a restr�onswhich may appy.
Y Y n1►
In consideration of the granting of this requested permit, I do hereby agree that l will, in all respects, perform the work
In accordance with the approved plans, the Florida Building Codes and St Lude 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 nim -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.
Luce County and posted on the jobsite before the first inspection. If you intend to obtain financln& consult
with lender or an attornev hafere cnmmencinew work or ramrding vour Notice of Commencement.
Rev. b/b/lU
iiTnatu'?"fbwner/ Lessee/Contractor as bent for Owner
Signature of Contractor/License Holder '
STATE OF FLORIDALC"f
STATE OF FLO A
COUNTY OF S
COUNTYOFC2*
Swom to (or affirmed) and subscribed before me of
Swo(or affirmed) and subscribed before me of
ical Pr ce or Online Notarization
, Ph caI Pr ce or _ Online Notarization
by
this ay of by
this ay of zo?a
Name of p6rsA maidng statement.
Ion
Name of person making statement.
Personalty Kn OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Prod
(Signaturqfof Nota
ture of ry Philac
Notary SUM Honda
Commission No. 1tlro
Commission No. Carolyn S u�-Pignane
My Commission GG 332348
Expir®a 05/=023
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ir
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