HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO'MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: PQ2i* 0 05Y
RECEIVED
� . • Building Permit Application AUG0771170
Permitting Departmer
Planning dnd'DevelopmentServll:es St. Lucie Countv
Building and Code Regulation Division Commercial Residential 4)(
2300V1rglnlaAvenue, FortPlerce FL 34982
Phone: (772) 462-1553 Fax: (712) 462-I578
PERMIT APPLICATION FOR:
Address•
Property TaxlD#:LM--70c -natRY-6on-3 Lot No. Fl
Site Plan Name: a o i . n , ax;� ' .3 A Block No. 3
Project Name: 49ot L�� lwaw Q.c� �.n ,,u ,JLt—ey -
135mlLED.DESCRIPTION-OF WORK:
New Electrical Meter Second Electrical Meter
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: g50 Sq. Ft of First -Floor: b S/Q /
Cost of Construction: $ 4,000. � Utilities: _Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name
Name:
Address,: sv ac 6b4
Company: OSS Pl a 4C
Address: Aa d,,
City: 12t� *State: y�
Zip Code: 3f�y'�_ Fax:
Phone No. IV JA i - %//S
E-Mail:
City: �m�in i�u D , Stater
Zip Code: Sy %A7 Fax:
Phone No77 51190
E-Mail ��o?n ilmyreJ a�i� er
State or County License CAr Jc2 2 7
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.
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: Ar— Not Applicable
Name:U et lP. !Aa
P. E.
Name:
Address: S6
O
Address:
City: a"
State:. L
City: State:
Zip: 3360 2 Phone
O
Zip: Phone:
FEE SIMPLE TITLEHOLDER!
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 Lucia Countv makqf no representation that is granting a permit will authorize th4 ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws r andcovenantsthat may restrict or prohibit such
structure. Please consult with your Home Owners Association -and review your Seed 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 n attorne before commencin work or recordin vour Notice of Commencement.
ig'oa re'of Owner/ Lessee/Contractor as a W—Wner
Sigrature ofinnfracior/License Holder
STATE OF FLORIDA
COUNTYOF SI•_ Lc; c
STATE OF FLORIDA Q�
COUNTYOF ..��ff
Swo o (or affirmed) and subscribed before me of
Sworn to for affirmed) and subscribed before me of
Physical Preseppce or Online Notarization
/1uaU—
sical Presehce or Online Notarization
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Name of person makingstatement
Nameofperso makingstatement
Personalty Known 2✓/OR Produced Identification
P onall K OR Produced Identification
Type of Identification
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SHE��\ oo �9�4�ti� e�a36y
( ignature of Notary Public- State o pad
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(Signature of Notary P
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Commission N /a,
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Commission No.
REVIEWS
FRONT
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REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
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COMPLETED
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