HomeMy WebLinkAboutFULMER-Permit APPAll APPLICABL,; MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: {J(/g_ i) Permit Number:
Building Permit Application
Planning and Development Services
Building and Cade Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address : 30,z,,o Qlz_t t!rw~ Av£.
Property Tax ID#: Z4ofi ,.. :32.-(j -oa:>3 -Ooo Lf Lot No.
Site Plan Name : Block No.
Project Name: \\ fu l r1-<1£,,rt_ ' '
DETAILED DESCRIPTION OF W ORK: w
-Cl.Ju?~ u NC:-(_ u ) Cf't:;_..\.-'l µ& w / 'L.,,.._P {).c..!( \Al l rJ DO\..J
f'x c~•n l\)(r f.J-~-}.)ot..J 't--M-c>At:r W 1f\/Oo w .
New Electrical Meter Second Electrical Meter
I CONSTRUCTION INFORMATION: ' I
Additional work to be performed under this permit-check all that apply:
~indows/Doors -Mechanical -Gas Tank _ Gas Piping -Shutters Pond -
-Electric _Plumbing _ Sprinklers -Generator -Roof Pitch
Total Sq. Ft of Construction: ¼ .5 e;
,
Sq . Ft. of Fi rs t Floor:
Cost of Construction: $ 2PI)(). cfo Utilities: -Sewer _Septic Building Height:
OWN ER/LESSEE: CONTRACTOR:
Name ~Of'Urfi. FW I M ~,,,i_ Name: tvf 1v\1.A-ti--\ w A\Cl,l t.P
Address: 38-Lo D~l ~P¢-t..6 Aur-e . Company: ~Ov'~\o('J (pw-rr~c.:'(""l
City: tfJ Fv..-:c:: 'P~~ State:& Address: 'vo <?,Q>'-3 -r'+7
ZipCode :3tf'i<-!"1 Fax: --
,
City : tt". <vi u:_u._ State:_£_\
Phone No. 7,,z,, 7~0 Zip Code : _:34jl./ 8 Fax:-
E-Mai l : -----Phone No 1,1..-03 t.t 7 '-f57
Fill in fee simple Title Holder on next page ( if different E-Mail M>JP.1\()1\.-d>~~~d'-J C.D"-'~t<-k.l \
from the Owner listed above) State or County License C/::r (.. IS:I f1l 'O '...P
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 requ ired.
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 Countv makes no representation that is granting a permit will authorize the permit holder to build the subject stru~ture h which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit sue
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, sere ms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Recor otice of Commencement may result in paying twice for
improve nts to your property. A ice of Commencement must be recorded in the public records of St .
Lucie C ty and posted on obsite before the first inspe ,on. If you intend to obtain financing, consult
with aer or an attor.ne 6efor mencin work or rec rdin our Notic f Commencement.
Swor.i:i,to (or affirmed) and subscribed before me of
..lL'.'.'.'Physical Pre ~~e or __ Online Notarizat ion
this _I_ day of ~ipt . 2020 by
N,m:=m•~~~f
Personally Known ___ OR Produced Identification __
Type of Identification
Prod d·----+-+--+-..,.,,__ __ _
al~pires Dec 1 .
lhrough Na \1onal Nol.ary
worp..to (or affirmed) and subscribed before me of
_V_ P Phhysical Presffce or __ Online Notarization
this __L day of pt . 2020 by
J/2 i ch o I Wo,2dvn11
Name of person
Personally Known ___ OR Produced Identification
Type of Identification
Produced ______ -+.,L---
olary Pu blic -Stale of Florida
.t.<;C-QPl'/lission # GG 167258
IIIY~llmn . Expires Dec 11. 202
Bonded through Na tional Notary A-.sn
REVIEWS FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR PLANS VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED ev.
REVIEW REVIEW