HomeMy WebLinkAboutRichard & Glee Warren permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
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�J t L U
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:
Project Name: _PVC_
New Electrical Meter Second Electrical Meter
WTI.
. ... ... . ..
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:
Sq. Ft. of First Floor:
Cost of Construction: $ _Q Utilities: Sewer Septic Building Height:
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Name— �n 0X_ Ir -6
Name �3
Name:
Address:
Company:. fRo
City: �- Pr �. �(•� State:
Address: �b 2:>0
Zip Code:.-2,Li 91-1 > i Fax:
CitState:
Phone No. '2 - C3 - �!
-
Z i p Code: "'S�0\ '7 Fax:
E -Mail:
Phone No- <i�u '7 %,4 � qO `7
Fill in fee simple Title Holder on next page if different
E -Mail
from the Owner listed above)
State or County License-I�l�
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.
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N TI
_ _ .._.
DESIGNE /
R ENGINEER: Not Applicable
.- ,.. � ._... :.: .. :.:.. .:
.-
MORTGAGECOMPANY. • Not Applicable
Name:
Name:
Address:-
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Address:
City • _ _ �
• - � State:��
Zip: phone
Cifiy; State: -
Zip: ane.
Ph
BONDING COMPANY: Not Applicable
FEE SIMPLE TITLE MOLDER: - Not Applicable
Name:
Name:.
Address:_
Address:
City •
'
City.
Zip: _ Phone:
Zip Phone:
OWNER / r r)PVTR A rTnD
- - - _�. - • wo'k r,f f 1W V f , • Hppiication 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 th
which is in conflict with an applicable Ho � P e subject structure
structure. Please consult with pyour Home �w®yrs Owners rules, bylaws or and covenants that may restrict or prohibit such
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 ects res er
in accordance with the approved plans, the Florida Building Codes and St. Lucie Co P p form the work
County Amendments.
The following building permit applications are exempt from undergoinga full concurrent r
accessory structures, swimming pools, fences walls sin Y review: room additions,
signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Comma •
improvements to yourproperty. A Notice Commencement may result in paying twice for
jobsite
of Commencement must be recorded in the public records of St.
Lucie County and posted on the before the first inspection, If
wit � er or an a bef®re c p you intend to obtain financing, consult
ommencing work or recording your Nec of Commencement..
Sig _ of Owner/ Le see/Co actor as Agent for Owner
STATE OF FLORIDA
COUNTY of �� .
K
Swor
to (or affirmed) and subscribed before me of
Phy ical Presence or Online Notarization
this ��� �R
day of , 2020 by
Name of person making statement,
F
Personally Known OR Prod
...� used Identification
Type of Identification
Irbp uced
- j
(i ture of Notary Public- Stat rida }N
SHA NON wArrs
co�IMlssloN #H
My H 43553
Commission No, 355)
Set}PIRES: SEP 16, 2D24
Bonded through 1 st Mate Insurance
REVIEWS I FRONT
COUNTER
DATE
RECEIVED
GATE
COMPLETED
ev. 17-a-^
Sign-4tcrFe of Contractpr icense older
STATE of FLORIDA
COUNTY of
Swor to (or affirmed) and subscribed before me of
Ph sisal Presence or Online Notarization
this f day of
2020 by
Name of person making statement.
Personally Known ` OR Produced Identification
Type of Identification
Produced
(Signa ure of Notary Public- Sta _ .
r ;-,0 � I ANNON WATTS
Commission No. 4 hIIISSION #HH 43553
I ES: SEP 16, 2D24
Banded through 1st Mate Insurance
ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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