HomeMy WebLinkAboutHuston Permit Appplication - 2709 Brantley Rd FPAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /r)oQ /ao aL_ Permit Number:
t: L UcLL
1 I'
t7 T ' 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:
I PROPOSED IMPROVEMENT LOCATION: I
Address:
Property Tax ID#: C q -a1)- RDa- r_�n7.5'- C)OC7-Y Lot No.
Site Plan Name:
Project Name: �n_:lA (-Lsl-cc) e5
DETAILED DESCRIPTION OF WORK:
�� rte_..♦_- /0^^ ..,-_'_-// i/ .-_
New Electrical Meter Second Electrical Meter
Block No.
I CONSTRUCTION INFORMATION: I
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:
Cost of Construction: $
Sq. Ft. of First Floor: _
Utilities: -Sewer —Septic
Building Height:
OWNS ESSEE:
CONTRACTOR:
Name AJCLCYN
14y4nC
Name:
ame:Address:J-)c'J
r
Address: J-)c'J
-
Company: hi-Nlc, cf-�- LL e Cba iJ�fli Fie s2C
City:�-V_ PtLCCk_ State: L
Zip Code: 3498 i Fax:
Phone No. - 5bI-ay/-5793
Address: KGS 33 C( SQ
City: Veoc ?:-'ea4�) State:i__7L
ZipCode:_3a969 Fax:7�a-5b9-SaS�b
Phone No 7-2a- 569- 3b917
E-Mail:ezq�?
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail Lisa ®(Jlci�S� �zekT+e , cocx�
tate r County License EL 13 0 o a 9
-rbue-u e
It 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:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address: !L,6mL n m o
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 1 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-4ommencing work or reco e your ice Commencement.
ncv. a/ 0/4V
nature w er essee tractor as Agent for Owner
atuiC of Contractor/License Holder
STATE OF FLORIDAtan
TE OF FLORIDA,,,,,,,
JANTY
COUNTY OFo �d I vas Co.
OF
Swo t o (or affirmed) and subscribed before me of
Presence or Online Notarization
Swop to (or affirmed) and subscribed before me of
fPhysical
I/ Physical Presence or Online Notarization
this _ day of 2020 by
_
this _ day of 2020 by
�40,� \C\.0 9A -on
Jobe J u \ �,- \ (� kA'{ -o K
I
Name of person making atement.
Name of person making statement.
Perso ally Known OR Produced Identification
Personally Known -L— OR Produced Identification
/Type Identification
Type of Identification
Prod ced
Pr uced
gnature of Notary Public State o ) Barbara M. Rmha
/'(Signature of Notary Public- of Float ftp. Resha
NOTARY PUBLIC
NOTARY PUBLIC
Commission No. I$TATE OF FLORIDA
Commission No. STATISMIJFLORIDA
Comrr* GG346694
'" = Commo GG346694
a
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SUPERVISOR
PLANS
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MANGROVE
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DATE
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DATE
COMPLETED
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