HomeMy WebLinkAboutFlorio permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number:
S �
I._ �J � CrLCC
®"m Building Permit Application
Planning and Development Services k
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:
Address
Property Tax ID ++ W2_3 � ` �-O/' Opo 1 -610 - ) Lot No.
Block No. t:� LSI
Site Plan Name:
Project Name: F D i• o Rwav-lc-
LED DESCRIPTION OF WORK:
n rw - .-L,k n1.Q n Q11 waad
6VJe44S COI(nix5 5AIVI* � V$IKa► 0/ "' Cw! l /1t� �J % pGr caw• -c ee _
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
Mechanical
_ Electric
Gas Tank
Plumbing
Total Sq. Ft of Construction: 11087
Cost of Construction: $ 1 �4 (OOb o a
Gas Piping
Sprinklers
Shutters
Generator
Sq. Ft. of First Floor:
Windows/Doors _ Pond
/� Roof / Z- Pitch
Utilities: —Sewer —Septic Building Height:
Name
Address: 3$(Q,57 IV f> )bwpw 41A
City: rf - State: _rll .
Zip Code: 3 ' `� % Fax:
Phone No. W'eg,- (5g,u
E -Mail: _
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: Davoi+ RiY�inz
Company: f ock sd/id Vo& ir'l /11 C.
Address: to 72- FT i2?h
City: Q 5�7'a w State:
Zip Code: Fax:
Phone No 31/ 7y `f - 76 &
E -Mail KOc-kso(idroj„C-O yQ kop.con
State or County License CCC. T'3 -.;i-kib ) i
If value of construction is 2500 or more, a RECORDED Notice of Commencement is requireu.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
NL CONSTRUCTION LIEN LAW INFOWATlON.
DESIGNER/ENGINEER: Not A licable
pp MORTGAGE COMPANY: wog Hppiicabie
_
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
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.
I
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 gain financing, consult
with lender or an attorney before commencing work or recording your tic Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of nl ct r/License Holder
STATE OF FLORIDA
STATE F FLQ DA
COUNTY OF :" �A'Q� �v
COU YOF-I-rtr►\I ✓e1
Sworn to (or affirmed) and subscribed before me of
11
sw()Vrto (or affirmed) and subscribed before me of
Physical Presence or �( Online Notarization
this/11 `I day of Ea4g2�� 2020 by
Physical Presence or Online Notarization
this �L day of }� ,` h{f- 2020 by
Y, I o
Name of person making statement. !
Name of person making statement.
Personally Known OR Produced Identification x
Personally Known V OR Produced Identification
T on
_
Type of Identification
Produced A f
Produced
(Signature of ry tic- State �': Notary Public-Stat
iglbia, of y Pu lic- St
=' ' Commission 11 G
Co fission N ��yS ''? MY Commissio
March 30,
286584 ,)� bus' Notary Public State of Florida
rTt( i �� (.t�f J Arnold
p0itiAiiss n o. y mission HH 011872
a Expires 06/17/2024
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.