HomeMy WebLinkAboutstojic permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
1.0
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:
PROPOSED IMPROVEMENT LOCATION:
�Slc�..r� �'-r�C.. �� [ o�� clo _ -'7�c_�t'c_.r1 �S�
�arcu �
Address: -7 S C
CrcS Pro-2c�-rc} <)nco-e- ir, cr>,r•r-^c.-� G?l�Yrw;�t� CJ� tl 1-7-11SS-)
Property Tax ID#: War-r,�►-��,c3 �- 000-0 Lot No.
Site Plan Name:
Project Name:
Block No.
[DETAILED DESCRIPTION OF WORK:
dv-i c, ss Q- SA I Sao k C-v"%CK Qc -2- 1 c�
2Sl
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
_J,Z,1-ectric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction;
Shutters _ Windows/Doors _ Pond
Gererator Roof Pitch
Sq. Ft. of First =1oor:
Cost of Construction: $ _ I . S (jo _.0 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
Name
Address: -1 i'3 ,a j-, r, I, LL+, C- C l
City:, '13c)CC-, (+"' °r State: -El-
Zip Code: "3 `-1 3 -'a Fax:
Phone No.-�Lcc*-t4-c id. o '�3-2 't,- 23 S'
E-Mail: 1
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR: r
Name: -c, v—c 5 'D ', r-u ,
Company::' vr, ,'ter-o",Y.�-
Address:335'2 01F 5ty_ltiw
City:y>�e,n �� Pc•c lti State:
Zip Code: Fax:
Phone No �5k4,-o-'5U3-- 53.33
E-Mail_S'3 33 al -y .VI CA
State or County License (L,J-+- n -3y S
E-V- 13o� 54 Sv
If value of construction is 2500 or more, a RECORDED Notice of Commencement is requ red.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNERjENGINEER: _Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Fhone:
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 -o do :he 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 hdder 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 resoects, perform the work
in accordance with the approved plans, the Florida Buildirg Codes and St. Lucie Cointy Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fe-ices, 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.
74
nature of wner/ Lessee/Contractor as Agent for Owner,' re of Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed? and subscribed before me of
rL�hyslcal Presence or Online Notarization C--Physical Presence or Online Notarization
this -ALVZlay of C si c 2C20 by this p6l"—day of . • • : v..:.. 2020 by
k-), t3 r-0 L . . 1
Name of person making statement. Name of person maki-ig statement.
Personally Known ✓OR Produced Identification Personally Known ___(e!!!:'OR Produced Identification c/
Type of Identification Type of Identification
Produced/ r W F, d o. r,� �v s t_- . c� Produced = lvr -4 r-Luy s
(Signature of Notary Public- State of r ., na ure Notary public- St p` Ada
t K 4REN CO E _ COMMISSION # G> f1
`_ MYCOAIMISSION#. G981g01,
I
Commission No(-'(- 1 U� 1 I' �� & a PIRES:April 23.20
" c Issio Na' Ioof .P•
s EXPIRES:Ap ':BQ j�WVTTThruNofaryRa;i:.Un
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Via,• f?
aF fit° Bonded Thv Notary P bk Wdawkers �• ::.,...... :� _
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEV'J REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.