HomeMy WebLinkAboutRiordan 1All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
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
l�
PERMIT APPLICATION FOR:
Address: �o rl(%1 L C{ � �U CLU
Property Tax ID #: 3 t
' Lot No.-��
Site Plan Named Block No.
Project Name:'' , 0;2N
I'C.r'"i(
New Electrical' Meter Second Electrical Meter
Additional work to be performed under this permit – check all that apply: .
_Mechanical _ Gas Tank —Gas Piping
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Constructioni ,4--� -
Cost of Construction: $ /� q � � 0
_ Shutters Windows/Doors _ Pond
Generator Roof Z _ Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
�� E LESEMI-1,�, . _
� &A
C®�TRI�CT
W
Name f10t L0 ��
Name:
P
Address: '4813 1- 0V1 G UDK
Company: J1t 19 A
City: State:VL
Address:00 1'5) 0,% C.oLd hav `i4- letoo
Zip Code: 2) `i U Fax:
Phone No. –4 S
City c9:[-DC1L IaT W,C�L State:-� �—
Zip Code: S 01 � �'D Fax:
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Phone No 4l -.2L(J2)&i
E -Mail r-oIn ► _ Q i(.,c Orf'
State or County License 1
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
•.,'}' Y e. .{' 3 A 5x' Z C r'9x H`'u 3 Y.i.R :.:;$ 2 x., ..y<s:-YR it"�� + 5 1'�i
S',UPRLENFENTALCONSTRttU kNLIN�LAWINFQRMiTIAON
kY§ Y4. k1.�T:'s'
#,,;1 r"Ea.35{tiY �h I Y i
_N 2P $fiy w,f
S' ntractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
,sr�+� .... »>`s.t,�si \i+'4.3 <,�' .. ti,?.�''dr'L:I b'£ #f{...�.:.v' .,7 A ..;::'o}"R% t;r,..4.z"S._ .3, :.z"
_;. . ...a'l. .rEjt
3i .;�'ic-.."Yt`,r Y``'.k: h"..`t%,+x•.YS.;rcu:.:> _. 3G.:5;'e-�,,.. '.'! s1 —.
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
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 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 thejobmtq before the first inspection. If you i btain financing, consult
verith Ipnrlpr nr^.�:,,.,�'—� afnra r menCing work or recordine v otice mmen meet.
Kev. 576720
ure of Owner/ Lessee/Contractor as Agent for Owner
S' ntractor/License 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
Physical Presence or Online Notarization
Physical Presence or Online Notarization
this �_ of N OWMI& 2020 by
this 97 of �1DV- InNL^-,2020 by
(d�ay�
:SCT �-1 a -
pday,
�"
Name of person making statement.
Name of person making statement.
Personally Known c e t 'i a I
Personally Known OR Produced Identification
Type o Identificatio ," Y P`ac Notary Public state or Florida.
n
Type of Identification
1-0 ` APOLI MIRONCHUK
Prod ed I ° •• �tS S Commission GG 098831
Produc d
o 7,o� xpi es 4 ,/2021
ign t re of Notar aV�Wrlr" to of Florida.
'd
( gnature of Notary P Ic= p a e o I
`*o
gp011 MIRON HUK
Notary Public State of Florida.
y9 �� My Commission GG 098831
Commission No. oa Expires, 04 1
ro�a�
, AI)OLI MlgPNCHUK
Commission No. a My CommkARaUG 098831
SOF oO Expires 04/27/2021
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev. 576720