HomeMy WebLinkAboutTuliano Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �5 (19 (2-0 Permit Number:
91r. ILLECON ---J1
O
1 Building 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: SfV\teV ( �y)t j'nStOl I lafm
PROPOSED IMPROVEMENT LOCATION:
Address:
Property Tax ID #: 9 — s W " 025S ' 000 - E Lot No.
M 3�J
Site Plan Name: ( � Block No. n
Project Name: N ( -144
DETAILED DESCRIPTION OF WORK:
New Electrical Meter 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:
Cost of Construction: $
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name `%
Address: ME K 1,
Company: a.MY SV
City: o-e State: -L
Zip Code: � 5 Fax:
Phone No. 1 i'-Ip2-- �Gy) - q I Cin
Address: e
�,
City:�Dft �` UAD- State:
Zip Code:34g52- Fax:-i^IZ Jn' I5-g1a
Phone No 1 12.- 5qs" C1 I a C)
E-mail: .C—C"
Fill in fee simple T41e Holder on next page ( if different
from the Owner listed above)
E-Mail manQ linen+@ (.00
State or County License � l4 2,g�:[
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE 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:
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
is
which 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 recording o r Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signatf Contractor/License Holder
tj
STATE F FLORIDg,
STATE OF FLORID
COUNTY OF +. (1�CA_r
1
COUNTY OF E Lp 6f,
Sorn to (or affirmed) and subscribed before me of
S orn to (or affirmed) and subscribed before me of
X Ph sical Presence or Online Notarization
Y
Physical Presence or Online Notarization
Y
this Iq dayof_PMJkASt 2020 by
this day of J 2020 by
l n Irn rr 17 i Frn nc-ecco
Fr(xnoelsco
Name of person making statement.
Name of person making statement.
Personally Known X_ OR Produced Identification
Personally Known X OR Produced Identification
Type of Identification
Type of Identification
P oduced
Produced
U'U�� �/vllJl
(Sig
Co m
�lIpV �V is
'^-Notary Public -State of Florida
S 6- Commission. # GG 352146e
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(Sig
Comm;
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= Notary Public -State of Florida
Commission # GG 352144S
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My Commission Expires
July 04, 2023
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nn�``� July 04, 2023
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