HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: / - ` • , % q- Permit Nuni
Building Permit
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
DEC - 9 2019
Permitting Department
St. Lucie County, FL
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
'P.ROPiDSED'IIN4P.RO,V,EMENiuL1 CATION
Address: 9400 POrtside Drive Fort Pierce, FL 34945
Legal Description:?41rm ?'jj' V1 CIA) 6?L`*�='Z- NY-3 I117
Property Tax ID M - ow - 4 Lot No.
Site Plan Name: Block No. 3
Project Name: A�lID f 10. Qi �FO I Qr
Setbacks Front Back: Right Side: Left Side:
Znca-I-V a+10Y1 clr YooC-YY10
_ HVAC _ Gas Tank _ Gas Piping
_ Electric _ Plumbing _Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ -1.51 (o ! y IfLC)
?hD-tDQ0l+aic Sg,5+Q,m
a that 1T t apply:
_ Shutters
_ Generator
Sq. Ft. of First Floor:
-Windows/Doors
Roof = Roof pitch
Utilities: —Sewer _Septic Building Height:
'QWNER',LESSEE:
CONI iRA T IOR:
Name Miguel De LaRosa
Name:
Address: 9400 Portside Drive
Company: Tesla Energy Operations, Inc.
City: Fort Pierce State: FL
Zip Code: 34945 Fax:
Phone No.26797463"
Address: 8500 Parkiine Blvd. Ste 100
City; Orlando State: FL
Zip Code: 32809 Fax:
Phone No. 48113 aa-eg23- /4-Gl) Lil CI- 1031n
E-Mail:OH n-r do D I ra-(-Ptil n - Co bn
State or County L�: ECl O06226
E-Mail: migueladeiarosa@aol.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
If value of construction Is $2500 or more, a RECORDED Notice of Commencement Is required.
SUPPLEMENTALGONSTRURION ILIIEN I MA INFORMATION:
01
DESIGNER/ENGINEER: _ Not Applicable
Names
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
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 ana 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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencine work or recordine vour Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA )l Q
STATE OF FLORI A
COUNTY OF r G U �l
COUNTY OF 0 rO
The f o' g instrypye t was acknowledge before me
this day ofUL SC'r 2Uby
The f going instrument wa&acow�ledged before me
thisidayof 20_aby
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Name of person making stakw, tE L/�FT
Name of person makin statement
Personally d Identification
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Personally Knowndo,
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�im/ission�''I' �,c'p'
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Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17