HomeMy WebLinkAboutbuilding permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ° 0.10. 2o2..o Permit Number:
C C -�.�.--
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 33a
0
Building Permit Application
Residential ;'�
2�-o5.7a1.C�10
Property Tax I D #: 3 • oco � 3 1 Lot No.i/2 4i t5
Site Plan Name: U�� �e./ �jur l�ac1�� Garae►��, Block No. 4-3
Project Name: 5v►.��2�N� Garc�eP 5
I DETAILED DESCRIPTION OF WORK: I
�oC-
.► + 6'a-z
New Electrical Meter J{q Second Electrical Meter P Pt
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
Mechanical
Electric
Gas Tank
Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ S o �'
Gas Piping
Sprinklers
Shutters _ Windows/Doors _ Pond
_ Generator _ Roof Pitch
Sq. Ft. of First Floor:
t
Utilities: —Sewer _Septic Building Height: 12�y
OWNER/LESSEE:
CONTRACTOR:
or —
Name T•o�oert \A41, ley
Name: dk.11Nev- ;L l r V1r1 k t
Address: 33o% Ave S
Company:
City: P7ort p►ei'te State: !
Zip Code: 3q"':1L11 Fax:
Phone No. 57101 31141
Address: 330? RVt
City: F-ort- P,crLe State:
Zip Code: 3`-•q W� Fax:
Phone No -772- 51a 31 tq
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
State or County License
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:C�e����f-�C� Dc51aig 6%,o%,l .LruL
MORTGAGE COMPANY: Not Applicable
Name:
Address: loo AVP, s� , -\-r 2.e:-:-
Address:
City: Fc*- PitrLe State: r-
Zip: 34'-�So Phone -7-7-,?. ,4614 zoto
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: R+6cr4- w,' Ieq
Address: 330"7 `4ve -J`
city: V76y-r P Lv IR
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: 3y9,4"2 Phone: ?'72_ $19 3%Ict
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 our Notice of Commencement.
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Signature of Owner/ Lessee/CoWractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORI
4,1
STATE OF FLORIDA
COUNTY OF i�
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
P ysical Pres nce or Online Notarization
Physical Presence or Online Notarization
tais day of X ( - C 2020 by ,
this day of 12020 by
7
Name of person making st ement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced 4 t% Dfi 77fl 7a e)
Produced
(Sig ature of N•P PATRICIAPATT RSON
•.••
(Signature of Notary Public State of Florida )
/ '.;: MY COMN ?,123564
Commission No
Commission No. (Seal)
'1, E. Nov r 3, 2021
'•: °; F; ° ' Bonded Th, Notary Public Under dtero
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Rev. 5