HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
.Date: Permit Number:
2008-0719
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:
PROP'OSED'IMPROVE[V�ENT-LOCATION
Address: �� �� C� 75. 0 c " 6n
Property Tax ID #: ` s- - too - ®® o Lot No.
Site Plan Name: W1y%dn.:1 i,fo IkC. C b.l 1.� , �- Block No.
c'P
Project Name: W r d'1[yAi N V• t k�
New Electrical Meter Second Electrical Meter
CONSTRUCTIQN 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: s d', 2061P Sq. Ft. of First Floor:
Cost of Construction: $ Y 3, 5 29. c* Utilities: —Sewer _Septic Building Height:
OWNER%LESSEE
,;` a
CQNTRACTOR
NameQ/,,,abr, i// !/.// &I c trr /b ,.4 `$! Au
Name: RAY C. APPLEBAUM
Address✓,:t>/ S 0,ex, A
Company: DRIVEWAY MAINTENANCE, INC.
City: Jeal,c e., & a. State: tf2-
Address: 1100 NW 73RD ST
Zip Code: 5*6-7 Fax:
City: MIAMI State: FL
Phone No.
Zip Code: 33150 Fax:
E-Mail:
Phone No 786-568-5004
Fill in fee simple Title Holder on next page ( if different
E-Mail Permits@driveway.net
from the Owner listed above)
State or County License 23500
If value ot-construction is z5uo or more, a KewKutu imorace oT wmmenremem ns requaeu.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
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SIIPPI MENTALCONSTRUCTIC3N
LIEN'LAW INt'QRMATION
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DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
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
7WAR OWNE .' our failure to Record a Notice of Commencement.may result in paying twice for
rovements to yo r property. A Notice of Commencemen ust be recorded in thepublic records of St.
e County and p ted on the jobste before the first inspn. If you intend to obtain financing, consult
with lender or a ttornev befoelcommencine work or reco dinkvamflQbtice of Commencement.
I
01 1 i5xv
ure of Owner/ Lessee/Contractor as Agent for Owner
7ntt!!u�* of Con or/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Sr Z4VhE:
COUNTY OF i i. cu.»: = �
Sworn to (or affirmed) and subscribed before me of
Swo to (or affirmed) and subscribed before me of
X PVsical Presence or Online Notarization
Physical Presence or. Online Notarization
this � day of AU Gll S�r 12020 by
this ay of 2020 by
90,66-4-r P. ba rrA A/0
Name of person making statement.
Name fper n makings ent.
Personally Known %� OR Produced- Identification
Personally Known OR Produced Identification
Type of Identification d
Type of Identification
Produced
Produced
i,
i n ur 4�5 t of Florida
(Signature of 1116ta lic- State Its ) NaifryAudl too of
,
Shttletic
Coammision CiG 24
Commission No. a9ty 23& � I �a1ti2o2a
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` commission 9 GG 418643
om ssion No. �� MY Comm• Expir1W.) 2023
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'SUPERVISOR
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