HomeMy WebLinkAboutCurcio Permit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
'� Uo L UFLDIE
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: 12e_
j PROPOSED IMPROVEMENT LOCATION: IL,
Address: tr0+2.5 S . CC-ean L7(', :r+-+O 64c
Property Tax ID #: 4511 ° 1 0zzf I - C ® Lot No._
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:" ,,:..,,�, , „ rAr,!_ ,r2_e'k _ _ , t) _ _ A
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 Windows/Doors _Pond
Electric _ Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction: 1L+S12 Sq. Ft. of First Floor:
Cost of Construction: $ -4:4 iU C-_0 Utilities: —Sewer —Septic Building Height:
OWNER%LESSEE:
CONTRACTOR:
Name Rc)r)'�AA CUYC.(u
Address: InfiZS G. 0U_0_n cir'" -#__�G
Name: - t)
0'-r-
Company: V-7/61
t�
� Its
City: o State:
Zip Code: 349, '�- Fax: 19-
Phone No. -11 LUZI • 02J�ob
E-Mail:
Address: [65q SIC; �3v_ , cr
City: q1T 9 T.Z('x') State:
Zip Code: Fax: 1�
Phone No -1.2- LP2 t - &Zr9
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail DP(I U '
GV-S ) I C tort'-)
State or County License
CCC [�)Zto4'
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 TITLEHOLDER: _ 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
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 lender or an attorney before commencing work or recording your Notice of Commencement.
Signature of Owner/
STATE OF FLORIDA
COUNTY OF
as Agent for Owner
Swor o (or affirmed) and subscribed before me of
Physical Presenc o Online Notarization
this day of 2020 by
Name of/person making statement.
Personally Known --- OR Produced Identification
Type of Identification,
Produced
I
(Signature of Notary Pu lic- tat
Notary Public State of
Pamela Jones
Commission No. q �c ,j"ak;ly Commission GG 9
W n. Expires o6/15/2024
REVIEWS I FRONT I ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Signature of Co
STATE OF FLORIDA G.;j
COUNTY OF"
Swor (or affirmed) and subscribed before me of
Ph sical Presence or _ Online Notarization
this 1"day of Otyti)1577— .2020 by
O_A_fYla Lt'-io ( tl �Pc'(-
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
of Notary Public-
ssion N
Notary Public State of
� Va Jones
Y mnussion GG 9
Expires 06/15/2024
S REVIIEWOR I REV EW NS I VEGETATIEV EWON I SEATURTREV EWLE I M E EWVE