HomeMy WebLinkAboutOct 5, Doc 2All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Planning and Development Services
Building and Code Reg
2300 Virginia Avenue,
ulation Division
Fort P
Phone: (772) 462,m.1553Ix
fierce FL 34-982
B uilding Permit Application
772) 462-1578
PERMIT APPLICATION FOR:
Commercial
Residential 0005��
PROPOSED IMPROVEMENT LOCATION:
Address: %�33 /�!W
;fu r'�7�3,4 f e,l�.CL E t�A�-rti S �ryf F�. 3`v9?0
Property Tax ID #ew �SC3 `4 4 S CPC cl-�
SitePlanNa e.o //49 800P*44= 123D&e - oLo E). 3 V I a.�ld-�
Project Name:
SCil/4AbJE
1 DETAILED DESCRIPTION OF WORK:
,4D� (a� srte►wL� do1rso vs
vT Ex�sr�•YG�vEsT 7,4/�
607,
cot N
W'W
Lot No.
Block No
'.ib 3
Co0A1 too/-'e� is
7-
440V 14(Z IVo-ow z.���r 4x0p,.�,00wslk
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be perfor ed underthisper it all that apply:
Mechanical
Electric
Total Sq.
Gas Tank
_ Plumbing
Ft of Construction.
Cost of Construction
_Gas Piping
^ Sprinklers
Shutters
Sq. Ft.
Generator
of First Floo
Utilities: Sewer
Windows/Doors Pond
Roof Pitch
r:
>eptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name �ee� G �tir"d�2AN SC9N46PL N ame:_�l�l,t7�2F t=,
Address: j6�3 NW Su=e��i3�)'CI�� Com a C"
City: (0p� ► �'y State: � Address:_ 3 let 4) E Cc, <311A e ! 12
Zip CodeeC:.Fax: — ��: �"� � r� 2 State��-
Phone No.
:;ZC� �� � ���� Zip Code: ��� �i� � Fax:
E -Mail: %OP.AyIrr SC� �pOL.CO►'� Phone No
Fill in-ee simple Title Holder on next page (if different E-Mail
from the Owner listed above) State or County license C
If value of construction
is 2500 or more,, a RECORDED No
tics of Commencement is required.
If value of HAV[ is $7,500 or more, a RECORDED Notice o
f Commencement is required.
16
40
OWNER/ CONTRACTOR AFFIDVITO. Application is hereby made to obtain a permit to do the work and installation asindicated.
I certify that no work or installation has commenced prior to theissuance of a permit.
St. Lucie Count
y 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.
Inconsideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perfor m the work
in accordance with the annroved plans. the Florida Rid1dino Cndpq anri St I iiciP Crmintv Amonrimpntr..
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:Vour failure to Record a Notice of Commencement may result in paying twice for,
improvements to your property. A Notice of Commencement m.- ust be recorded i n the public records of St.
Lucie County'I
d posted on the jobsite before the first inspection. If yob intend to obtain financing, consult
with lenderran attorney before commrA; cine work or recording vousoNotice of Com nce ent.
dP
Signatureof owner/ Leazou e/Co n tractor as Agent for Owner Signature of Contra ctor/Lice nse Holder
STATE OF FLORIDA
COUNTY OF
0
5�y�orn to (or affirmed) and subscribed before me of
�!-� Phvsical Presence or
MMW
this d.5 day of
Name of person making statement.
mine Notarization
AWO J, Zola by
Personally Known OR Produced Identification
Type of Iden "fication �\
Produced J�j„�"PWAAL� �
(Signature of Nd
Public,* State of Florida
Commi;ssion Flo.co!a� I
�
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
'M
ev, 5/6/20
FRONT
COUNTER
STATE OF FLORIDA
COU.NTY OF
e. C�OLMMPPO-
Sworn to dor affirmed and subscribed before me of
Physical Presen or Online Notarization
this *t"'day of t6wo%MJ2020 hy
Name of person making statement.
Personally Known J
Type of Identification
Produced
SHIRLEY ; S
V jP4 if
Se�RAary
Lorrnllsslon
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2021
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of y Assn.
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EVIEW
REVIEW
OR Produced Identification
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ature of Notary Public- State of Fl
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REVIEW
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