HomeMy WebLinkAboutDalessandroKimAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
`�L..L, c"L
Building Permit Application
Planning and Development Services
Building and Code Regulation Division COn"imercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: f772) 462-1578
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PERMITAPf]LICATION f':OR:�in�01 �0+'0n
PROPOSED IMPROVEMENT LOCATION:
Address: Ck_.�..... //�ss,, 4 —
Property Tax ID #: 00 D5 — VCO " O Lot No.
Site Plan Name: , �.# ,ter Block No. �
Project Name: LP�Cs�G K. J r-0
DETAILED DESCRIPTION OF WORK: 11
—I ..-.c I r;� , , — ,172 r"—\ I ^ ✓ r 1 l _ 1K 4
HEW
New Electrical Meter
Second Electrical Meter
I CONSTRUCTION INFORMATION:
Additional work to be performed under this permit check all that apply:
TMechanical — Gas Tank —Gas Piping Shutters Wihdows/Doors Pond
Electric Plumbing —Sprinklers — Generator — Roof � Pitch
Total Sq. Ft of Construction: J_ _ Sq. Ft. of First Floor:
Cost of Construction: $ a300 • Utilities: —Sewer —Septic
Building height: _
OWNERAESSEE: - - - -
CONTRACTOR:
Name...
Address:I R I Cir.tr
Name:
Company;
City: —State: ELI
Zip Code: Fax:
Phone No. —'
Address- kQ Q
�jQ1�Cf'
City: F-3. L
Zip Code: 3195S Fax:
Phone No ( 2-3 DI�4
State:_E.�.,
0"! _
E -Mail:_ _
_
Fill in fee simple Title Molder on next page [ if different
from the Owner listed above)
E -Mail q
State or County License
1
If value of construction is 2.500 or more, a RECORDED Notice of Commencement is requirea.
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:_ Stater _
Zip: Phone_ _
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 yoLr Horne 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 reviewi room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residentfal 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,
Rev. 5/6/20
Signature of Owner/ Lessee/Contractor as Tnt for Owner
Signature of Contractor License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF 'LU
COUNTY OFSili L_L.4(-,
Swo}n to (or affirmed) and subscribed before me of
Swrn to (or affirmed) and subscribed before me of
�f Ph sical Presence or Online Notarization
� Aay
°✓ Physical Pres nce or Online Notarization
this of m' , 2020 by
x.114 ��1��
this ;?lay of �3ry- 2020 by
►�`1 l'eL .�'�'
Name of pers n making
-
Name of pe son making statement.
Personally Known �% r rp, uce� n ifz a"tl`cSE _
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Type of Identification°" P°�-
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ersonally Known TP° _�8 ,404r q � a
ype of Identification : a;a7 # GG 96783
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Produced 7
roduced •� Expires
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida
Commission Np, (Seal)
Commission Non (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
Ri
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20