HomeMy WebLinkAboutMUSGRAVE Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2 2� � Permit Number:
�o 0.
Building Permit Application
Planning and Development Services /
Building and Code Regulation Division Commercial Residential V
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address: �(o�)01 Wl�i'I{ VI(�1Y(11.{ �1rr t' ��1 ���1�� �itV(, ��� '3 Cl 17 I
Property TaxlD#: I�JIgI�� U3�>-�,y®� (9LotNo.IO
_
Block No. I�
Site Plan Name:
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit– check all that apply:
Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: ZC� S
Cost of Construction: $ Ll i Si U
— Generator
Sq. Ft. of First Floor:
✓Roof
U 12 Pitch
tilities: _ Sewer _ Septic Building Height:
Name Hufln sl(A IVI A % w %Vk\- n My _U
Address: C� U'0} \N\y\"Y h(�Y(�AV1 PUN
City: l%IJH- �l- y _State: rL
Zip Code: �JiI°15 I Fax:
Phone No.
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: N fit I V 011t
Company: Offs
Address: I -LC MCA IVI' � -
City: WWI V wu i1 Staten
Zip Code: �'�1 kU Fax: LI' �j
Phone No SOLI' lQ 6 3
E -Mail Dff I Lf (BIAS IVVICII Ilh�l IIYi'I I kr�ln�a a r II T
State or County License
If value of construction is 2500 or more, a KtcUKL)tu Nonce yr 11..UrnrnCIMCnICIIa =Mw, _�•
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: ✓Not Applicable
Name:_
Address:
City:
Zip:
one
State:
MORTGAGE COMPANY: '✓ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: /Not Applicable
Name: AUM jai S S yCA Name:
Address: 00i YGU Address:
City: _ V_4- lily City:
Zip: c'l S I Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 thepermit 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 post d on the jobsite before the first inspection. If you intend to obtain financing, consult
.
A" 1 - — ++., ham„ -o e'nM OnrIna Wrirk nr r w-nruing your Notice.6fiComr&ncement.
Rev. 5/6/20
v
Sig a of Owner/ Lessee/Contractor as Agent for Owner
t�
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIQi4�,�
COUNTY OF
COUNTY OF �VYY ISA
S A -G nd subscribed before me of
Sworn and subscribed before me of
��� Online Notarization
�CMsicLal Prese ce r Online Notarization
this day of V 2020 by
thisay o 2020 by
l � �
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Name of person making statement.
Name of person making statement.
sonally Known 'OR Produced Identification
Kn w OR P pc{uced Identification
Type of Identification
Type of Identification j I(�'(�y
Produced
Produced ;=o":::;"-, ELEYEHRENREICH
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Commission # GG 951923
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3 5-7019 fission No �5�a23 (Seal)
Com s NoC�
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20