HomeMy WebLinkAboutBuilding Permit Application rCpV(kk Vats lb cKbmtq\S �
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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: `
AA61 �.
Address: 2'IO �UlyatT>a► vt�l.
Property Tax ID#: 1431 0 Ct"'=4 ow Lt Lot No.
Site Plan Name: EV ATOK Block No.
Project Name: r
IT
UN-
&'?R,i7adc a. i ft_1
Ev. Y
New electrical Meter Second Electrical Meter
t r' .. t"a '9 i:rk g 3.�t....n s., "Sv'�`., �•.�.s
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank —Gas Piping _Shutters V Windows/Doors _Pond
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
t'1
Cost of Construction:$ Utilities: —Sewer _Septic Building Height:
Name .ErArR . MC CIA,1W Name: 5MR1. F90z1W1
Address:2,104 Wtslgim 1w. Company:&SrttiLE COW.'
City: ;b12T MVMCS! State: FL Address: _61({&._fbME',
Zip Code:34 Fax:_ City:� i;T !ELM 6eAC44 Stater
Phone No. Zip Code: 3 1, �Fax: "
E-Mail: Phone No
Fill in fee simple Title Holder on next page(if different E-Mail3
from the Owner listed above) State or County License
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.
SIGNER/ENGINEER: Not Applicable RTGAGE COMPANY: _Not Applicable
Nam Nam .
Address: Address:
City: State: City: State:
Zip: ne Zip: P e:
FEE SIMPLE TITLE H9LDER: 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
which is in conflict with any applicable Home Owners Association rules,bylaws owao&couang*pts!Ut-46t prriaytrestfict or prohibit such
structure. Please consult with your Home Owners Association and revievgour deed fpr any restrictgc ns which Vay apply.
In consideration of the granting of this requested permit, I do hereby agi-ce that t wilk ih all respects;-perfar`irt+k work
in accordance with the approved plans,the Florida Building Codes and St. Lucie County.Ameqdmeotks.°, , °• }
The following building permit applications are exempt from undergoing a full concurrency revievy:.room a�ccnigns,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to anoti er4ion�r`e-44ential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in paying twice for
improvements to your property:PhNotice of Commencement must be recorded in the public records of St.
Lucie C unt and p sted on the jo site before the first inspection. If you intend to obtain financing, consult
with I d or n tt e befor commencin work or recording our Notice of Commencement.
°.. ,L
wrier Les a ntr cto as Agent for Owner Signature of Contractor/Li ense Holder r
? LOR
F STATE OF FLORL
OF COUNTY OF
S7,,n to(or affi ed)an subscribed before m of Swor o(or affirmed)and subscribed before me of
oPbysical P s e 0 line Notari tion ysical Pre nce or Online,N,00ta`rization
this njayf, 2 ythis day of 21bY
1 L`� bsct�.�. FCzoZt�e
Name of person making stateme t. Name of person making statement.
Personally Known OR Produced Identification Personally Known V" OR Produced Identification
Type of Identi anon Type of Identification
Produced I •(.. Produced �r
In
(Signature o ota (Signature f Notail
.�jRrr No�ta�Publi S�brFlorida < : rP alotQcyu6hcW Florida
Commission No. ° abeNiNmef" Commission No. • rybeil �► �9
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f ,.r •_y�ZainirrispiianGG27fl97S ~`yip' ' Expires 1(/2Ai,207 a.D4°, «E5c�ires 1024/0212•.>» .,; .
REVIEWS FRONT ZONING r' S'UPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNT,kk', IREVI'EVV ` ;'": "• REVIEW REVIEW REVIEW REVIEW REVIEW
DATE r
DATE
COMPLETED
Rev.