HomeMy WebLinkAboutGreehan Permit Application08282020All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: `ci.C% Permit Number:
Building. Permit Application
Planning and'Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial Residential
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION: n atic( lf' -
Address: 7UC&) _C7c�.C�-rl _ �_ReyKIt11
Property Tax ID #: �56 06a.c0 -vc Lot No.
Site Plan Name: r O.-+ r c�� Block No.
_(SiProject Name: u- 4,_ Vb\, n _
DETAILED DESCRIPTION OF WORK: ibll
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
Electric Plumbing _Sprinklers
Total.Sq. Ft of Construction:
Cost of Construction: $ a I , ,-,) C', (.0 .
OWNER/LESSEE:
Generator
Sq. Ft. of First•Floor:
Windows/Doors _ Pond
Roof Pitch
Utilities: —Sewer —Septic Building Height:
Address: ZJ A 0DSCXA C14k h r I 0001
City: �P�S r 1 l� r State:
Zip Coder L((1s!2 Fax:
Phone No. 9 0q - 5--) 5 -49 11
E-Mail: CA , c), _e.,e k CL-AD 11 t 4 Y3c tP,. nit"
Fill in fee simot Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
Name
CompanyT-!Q Pprl-rtl
Address: Cs�cs
aty:Q�:gState:
Zip Codetb L46?s o Fax:
Phone No _ a-?s % -
E-Mail h Ssl
State or County Licens �l
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
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
Address:
City: State:
Zip. Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
l 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 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, wails, 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-4ende"r an attornev before cnmmpnrinQ wnrk nr rPr_nrdino vnur Nntirp of CnmmpnrPmpnt.
Mg'-natlire of Contractor/License Holder
Signatur of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
STA E OF FLORIDA
COUNTY OF i
COUNTY OF
Swo oto (or affirmed) and subscribed before me of
hysical Presence or Online Notarization
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
t is day of _ 20^ by
this day of 20_ by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Publi - o Florida }
(Signature of Notary P - State of FI a )
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Commissi o. COM92#GO316620
PAY
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Commissio " * Co1 t��lo
8620
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�t Expires July 28, 2023
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; Q;Pr Explrea Jul 2
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