HomeMy WebLinkAboutFOLBRECHT-permit App' '
All APPUCABLE INJO MUST BE COMPLETED FOR APPUCATION TO BE ACCEPTED
Date: _8/16 /_j,,(} 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: J;,.}jr/}l.t,,Af"tf)IJ or ::Z.::r-1PA-{,'f t-v•t-lDcwS.
PROPOSED IMPROVEMENT LOCATION:
Address: 7 'IIJO f> It, OS ll~h"I)
Property Tax ID#: 2~ I '1 -/ S 3 -000 I -..-ft:? Lot No . ___ _
Site Plan Name: _______ -,--______________ _ •' ..-'.:... ,, Block No. __ _
Project Name: r-v/,.{?AfC-/-f.-C
DETAILED DESCRIPTION OF WORK:
W I 0(:,..,J,5
New Electrical Meter ____ Second Electrical Meter ____ _
I CONSTRUCTION INFORMATION:
Additional work to be performed under this permit-check all that apply:
_Mechanical Gas Tank _ Gas Piping
Electric _Plumbing _ Sprinklers
' Total Sq . Ft of Construction: ~00 5 2 I
Shutters
Generator Roof
Pond
____ Pitch
Sq. Ft. of First Floor : _,qf=I--'----------
Cost of Construction:$ 2-8,ooO I Utilities: _ Sewer _ Septic Building Height: ___ _
OWNER/LESSEE:
Name Mu.I f...b~ll H :r::
Address: 1'[02 'y\ U6
City: p I f.,vl,, ( w State: &
Zip Code: ?ft qq Fax:·---,------
Phone No;g?,,--f3;Y-l --7t./£1 ·
E-Mail: /{)r
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: t1 IC HA:i I lei At..oMf
Company: 1: N (\) ov Aj\ OVv u:>tJ'lh...P'-t,'f"'l ;:) (r-
Address: 9 1) .$7'-t1 Fr ~ucO.
City: .31...f 1 ':t 8 f._ 9,e/LCI[. State :-1::f-•
Zip Code: :72 4ii/'2 Fax: -"'"
PhoneNo 1,,,. 1 S
E-Mail IN J:H,. V\IW~o"N
State or County License C Cs-l I s=I I "II()
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: 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 .
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
improveme ts to your property. A Notice of Commencement must recorded in the public records of St.
Lucie Cou y and posted on the jobsite before the first inspection . ou intend to obtain financing, consult
with le er or an attorne before commencin work or recordin ur Notice of Commencement.
S~n to (or affirmed) and subscribed before me of
_·_Physical Prese!°e or __ Online Notarization
this L day of ,sgeJ= , 2020 by
Nai~~d m~i~~nt.
Personally Known / OR Produced Identification __
Type of Identification
Prod ed. __ 1~;;~~~~;;;:;~~~;;--l
'4,l,,ll,<.111.,~..-..i,."--oOOe<l th1c(S"ea1fnal No\;11yfl.s~n
Si
ST TE OF FLORIDA G '
COUNTY OF Q Jf J e_
Swo!J(to (or affirmed) and subscribed before me of
_I/_ P /hysical Presn nce or __ Online Notarization
this day of 1/'C , 2020 by
NichJ M/oJdroe
Name of person making stateme~t.
Personally Known / OR Produced Identification
Type of ldentificat~
Produced ___ ~t--if-7"----
omm . Expires Dec 11, 20 21
Co . . . . laryAssn
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
DATE
RECEIVED
DATE
COMPLETED
ev .
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW