HomeMy WebLinkAbout5060 West Virginia Permit Application Correcteda,,br ed tl(o3
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 031GLm Permit Number:
��1r ; - `C LL
I✓ 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:
Address: L�UQCI1 WW VIW1174 Q&1.: lTOZ t Bei-ee F& g-Jqd'/
Property Tax ID#: 3"7®3 J°, ' Q171- OV -04 Lot No. Iq
Site Plan Name: Block No.
Project Name:
I DETAILED DESCRIPTION OF WORK:
�Sk # Abl:rhel-i�'
lele/
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 _ Shutters _ Windows/Doors Pond
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: 1514,
Cost of Construction: $ N 50-0
— Generator V Roof 9/1 of Pitch
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height:
OWNERAES5EE:
CONTRACTOR:
Name,r 0
Name:
Address:
Company:
City: State:
�.
Address: Kin
I
Zip Code: Fax:
City: r
_ r f plea u
State:,
Phone No.
Zip Code:
Fax:
E -Mail:
Phone No 1 - C
-I I!
Fill in fee simple Title Holder on next page (if different
E -Mail MA 6v
-k 11,0.
from the Owner listed above)
State or County License
C t - �i (
VQ "= VI {.{/1140H " Ulf IJ G7{/V V� IiIO(@, d ISCLVRVCY NOXIGe OT LOmmencement Is required.
if value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
Name:
Address:
City:State:
Zip: P e
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City v State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTO FIDVIT: 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 andcovenantsthat 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
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 th f'
with lender or an attorneybefore commencingworii k or ecordinn Tour Notice of CommencOU inend to obtainlement. consult
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF NTY 01`__FLORIDA
STATE OF FLORIDA
COUNTY
-�J-c
OF
Swgrn to (or affirmed) and subscribed before me of
'V Ph sical Pres
SwV� to (or affirmed) and subscribed before me of
ce or Online Notarization
this day of (➢ 2020 by
Pflysical Presenge or Online Notarization
this � day of N 0y�,I/ 2020 by
L �.1, C�,ut � ���
� � �„�
►it��i
Name of person making statement.
_
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Personally Known ,/ OR Produced Identification
Produced
Type of Identification
Produced
(Si a of -5 � I0rgZ2604
x
(5' ture of 1.8n P eW
US
Commission Nx* WWI: 0 � 14, 2023
iI1N AgaNO
EJlp�e=:October 14, 2023
ommission No.
jI
Am AIftiNoWy
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW
DATE
REVIEW REVIEW REVIEW
RECEIVED
DATE
COMPLETED
ev.