HomeMy WebLinkAboutBuilding permit app07/21/2020 13:13CARPORTS ANYWHERE (FAX)352 468 1116 P,001/006
All APPLICABLE INFO' MUST SE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
•
BuIlding,Permit Application
Planning aiid'DevslopmentServices
Building and Code Reputation Division Commercial Residential
2300 Wrginla Avenue, Fort Plena FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 ,
PERMIT APPLICATION FOR:
I PROPOSED -IMPROVEMENT LOCATION: i
Address:
-S I", LJ
Property Tax ID #: 3�I P •- 5(A O - c co $ — CC CJ -0 Lot No.
Site Plan Name: m\01 O.Q \ i-OSV-Y Block No.
Project Name: M i (' h aL I l -n 1f. Y
AETAILED:.DESCRIPTION,OF WORK: i
New Electrical Meter. Second Electrical Meter
i CONSTRUCTION INFORMATION: I
Additional work to be performed udder this permit -check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ 5hutters _ WindowF/.Doors _ Pand
_- Electric —Plumbing _ Sprinklers _ Generator _ Roof Pitch.
Total.Sq. Ft of Construction: I k Q Sq. Ft. of First -Floor: l c - 0
Cost of Constructlon: $ \Q), Sq) 2p-- Utilities: _Sewer "Septic Building Height:
OWNER LES5EE:
CONTRACTOR-.
Name f" 1 !t 4 l os
Name: o-Afyle s pl e r
Address: 1Jf-, F:;SbO, L .r
.Company: CargortS U)
.0iLP
Clty:CTV+ S`� C'l`e State: F:A,
Address: t7.
Zip Code: ;SUckJ63 Fax!
City: 5t 1VIG - StAtt �`
Phone No. a — (A&6 - IS 0,c
Zip Code: 32(?°) Fax:
E-Mail: 7 v t. cNtS V
,Phone No _4 �—
Fill In fee simple Title Holder on next page (if dlffere
E-Mail 11 C YES
from the Owner Ilated above)
State or County License
lrvatue of•constructlon Is 2500 or mere, a•RECORDED Notice of Commencam®nt Is required.
O value of HAV; Is $7,500 or more, a RECORDED Notice of Commencement Is required.
.coo
i SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION-,
R" _
Name:
Address;
City: State:
ZIP., Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address;
City;
Zip; Phone:
MORTGAGE COMPANY: — Not Applicable
Name:
Address:
City: State:
ZIP: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address;
City:
ZIP; Phone; --- _--
OWNER/ CONTRACTOR AFFiDVIT: AppilCatlon Is hereby made to obtain a permit to do the work and installation as Indicated.
I certify that no work or installation has commenced prlor to the issuance of a permit.
St. Lucie County makes no representation that is grentin a permitAlut rite the ermlt holder to build the subjectstructure
which Is in conflict with any pplicable Horne Owners A , cciation rulas, byy�a�ws Cr a covey ants th% may restrict or prohibit such
structure, Please consult it your Hhome Owners Assodatlon'and review r 2e or an restrict ors which may apply,
In consideration of the granting of this requested permit, I do hereby agree that I will, In 911 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, swlmming 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 ]obsite before the first Inspection. If you intend to obtain financing, consult
iulth lender nr mn n+*nrnwv kafewn rnmmunrinerwnrk nr rarnrdino vnur Notice of COmmencernent.
Sig tune of Owner/ Lessee/Contractor as Agent for Ownsr
Signature of Contractor/License Hold�r
STATE OF FLORIVA
�Tl��*`I a
STATE OF FLORIDA
t'RA-C>F0
COUNTY OF
COUNTY OF
Swo o for affirmed) and subscribed before me of
Svyorn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Physical Presence or Online Notariiation
thiiss _, da of 31t l r✓1 .20 �v by
this 92 day of -A +-i� us 1 .202 by
fy
I' `( C' `A-`Li� -Tk �®•S te,r
JArytES AOL..A-c/E�
Name of person making state it.
Name of person making statement.
1`
Perseral{y Known OR Produced Ice i.t fication
Personally Known OR Produced tdentifkatlon
tt(pet>f ld ttfl ati /
Type of Identification
roduce \ /
Produced
I
(Signature t
Public- Sta �d� FRANCIS FORKS
(51Rnat aofNota
I, ARIA
JDfry
commissio[' I J 3 �' 73 " P ` Notary Public - State
;.; I Commission«GG11M1
f Florida ;fir• • •... R. BURGIN
on No. = Commission�k462849
My Comm. Expires 0
8, 2021 _:;;;., o;' Expires August 25, 2023
' OFF` nnd2tllhrou hNational
olar Assn. "� `lP
REVIEWS
FRONT
ZONING
SUPERVISOR
PLAINS
VEGETATION
SEA TURTLE
IOU
A
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
nev. �ro1cv