HomeMy WebLinkAboutPermit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
J 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: (310 0V J2 N!-JA\JrtZ- Fr P,Cece-
GI. ��19yS
Property Tax ID #: 2 i 1 7- 3 " 0yc) 3 Ua0 - 1; Lot No.
Site Plan Name:
Project Name: 9 (cy)IhP;2f� P e
DETAILED DESCRIPTION OF WORK:
0
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
Electric Plumbing _ Sprinklers -Generator Roof _
Total Sq. Ft of Construction: Zq ot
Cost of Construction: $
Sq. Ft. of First Floor:
Utilities: _Sewer ✓Septic Building Height:
Pond
Pitch
OWNER/LESSEE:
CONTRACTOR:
Name C-It�C S1r-1]1be,-'.;
Name: 7aAVC 6 16»
Address: 13t45 0cpCNkAyelL JU
Company: Sl4ct:CDf2z
'Dc�5tC'
Jc>Z t4a-lt3
City: Ft o"EvtCt State:
Zip Code: 3 4 c 4 5 Fax:
Phone No. 7 7 2 21 S I t-- 7,-7
Address: -339 ?_ Z5k74.7^d
AVC S -TE I
City: PCX I M e, 4 h
Zip Code:144190
Phone No
Fax: 772.5q(�-SNLO
Stater
E -Mail: L` 7kNl I br.^c, 1 1 Gly1A%� . CciY)
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail hYAnc) I D�7CIS
CSlgneYbt w5.
State or County License CCL 1.33113
2
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:
Name: WeL-Cl•f
Not Applicable
MORTGAGE COMPANY:
Name: 4CAr7C�MY MDQiG'A-Cr
_ Not Applicable
Address: lq(0�1 5w 31tin,oRr
D/L
Address: 3235 0ip,",
Nap L_ •D0..
City:lo2t 6F "LC I L_
Zip: 34-'Iti4 Phone -112
Stater
7e3 `fisnL>
City: Vero 640LSA,
Zip:3T_eL3 Phone:
State:lr I
772--Z-34-o,04.(,
FEE SIMPLE TITLE HOLDER: _
Name:
Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
Address:
nown
Personally KOR Produced Identification
City:
Type of Ideificatio
City:
Produced
Zip: Phone:
q
)
Zip: Phone:
6 s.", CNAMARA
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
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 fir Inspection. If you intend to obbtain financing, consult
with lender or an attoroey before commencing work or cording your Nptice of CiOnmencement.
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Signature of wner/ Lessee/Co actor as Agent for Owner
Signature of Contra or/ cen Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF MCA,
COUNTYOF WdVQYk%n
'w7to (or affirmed) and subscribed before me of
V
or
Swto (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Physical Presence or Online Notarization
this Il day of IS"er(�2020 by
this Ik day of S1041!MW 2020 by
(nope S-4nwIrti a
1N\jA fan Genoe
Name of Pierson making statem t.
Name of person mak' g staterfient.
Personally Known V OR Produced Identification
nown
Personally KOR Produced Identification
Type of Identification
Type of Ideificatio
Produced A
Produced
/�
q
)
6BRA DYN MCNAMARA
6 s.", CNAMARA
(Signature dif
(Signature f Notary8 li (aFao &0#.6lsioN 0 GG032190r
7tapFft7ifi�1t6�W*bS)ONGG032190
27, 2020EXPIRES
November 27, 2020
Commission N
Commission No. "' Seal
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.