HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I,, �--,l - Permit Number:
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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:
PROPOSED IMPROVEMENT LOCATION:
V
Address: ► 6D S. {�Yoc�V�Svw+ S h�
Property Tax ID #: X3 ao — S01 ' OO` -1'1 — L_'O�_ F Lot No. )
Site Plan Name: cP MC. 44rl-c-h 5mm Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
New Electrical Meter
I Ac, I.P >Cct44r' IV
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: - `!00
Cost of Construction: $ a 1-7, q10
Sq. Ft. of First Floor: QL8-3zz:)
Utilities: —Sewer ` d Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name JvA&+kon Seti-ono-y 664-12!2�1 l�uiry
Name: -3d n A. C�v�ze-
Address: I LoaU H&wA� ,orfte Plate,
Company: �� �dxs
City: w i✓1 r State: FL
Zip Code: 3341LI Fax:
Phone SU S- 351- ly Los
Address: 51k 5\0 QSL mQs-
City: Nrk 5a• LLt6f, State: F -1 --
Zip Code: 3 N 1 S 3 Fax:
Phone No -l)'2-- 33 (-f- 7Q53
1N"o.
E-Mail:b(,;"�Y-4-+4m Qw" -
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail To'" 0 q rezo-- ba;i1J 'S
State or County License C�rrC. i 5 a 4'13N
If value of construction is 2500 or more, a RECORDED Notice of Commencement is requires.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:Lkr;s Rpf rs
_ Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address: 51061tl
Wa
Address:
City:
Zip: Phone:
State:
City: DV'k State: C L
Zip: 3q aL4l Phone lql - &a$- OU35
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
Address:
City:
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 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 recordirig your Notice of Commencement—
Sigy(ature of Owner/
as Agent for Owner I SigrXat,Gre of Contractor/License Hbl
STATE OF FLORISTATE OF FLORIDA
COUNTY OF JI . .L.kC,,(L COUNTY OF
Sworn o (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of , S u _'2020 by
Name of person making stat4nent.
Personally Known OR Produced Identification
Type of Identification
Produced
(A J
(Signature di Notary Public- State Flor'
ANGIE FINLEY
Commission No.MISSION#GG 3%153
��
E)(PIRTES' . November 17, 2023Utxferv+rite
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this _91 day of'i�1M 2020 by
-)n An�r'�i:n6ja-,
Name of person making�e nt.
Personally Known OR Produced Identification
Type of Identification
Produced
atur'e)of Notary Public-i5kate of
mmission No.
AN IE FINLEY
MY do*A ION # GG 356153
EXPIRES: November 17, 2023
SUPERVISORPLANS VEGETATION r SEA TURTLE MANGROVE
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