HomeMy WebLinkAboutApplicationAll APPLICABLE INFO MUST BE COMPLETf�D FOR APPLICATION TO BE ACCEPTEb
Date: f !%/ Z �ZD Z!)
Alarming and Development Services
Permit Number:
Building Permit Application
Building and CodelieguiationDivision CD!'1'ltl'lE?rClal � Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: {77Z) 462-1553 Fax: (772} 462-1578
PERMIT APPLICATION FOR: -
PROPOSED IMPROVEMENT LOCATION:.
Address: 3 5 � S l rfi, CfzC�� F" 3 Gj �
Property TaxlD##: L`i3`l _�G�I_C'C'-��—C�C�-� Lot No.
Site Plan Name: S�C� L[�(gISTICS CE lV Tt i2 61ock No.
Project Name: SL C L.faGI S TI C5 H VP�C M L-'� �r�r�,E „� S rU r�t4�rE
DETAILE❑ DESCRIPTION OF WORK:
C.Ca� R.� U1� � NE � r x `� iNT f�lo �}NIIU�
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _Gas Tank �. Cos Piping _Shutters _ Windows/Doors _Pond
Electric _Plumbing _Sprinklers _Generator � Roof Pitch
Total Sq. Ft of Construction: � � Z 5q. Ft. of First Floor:
Cost of Construction: $ � C�, (o� � " 4 O Utilities: � Sewer _Septic Building Height:
OWNERf LESSEE:
CONTRACTOR:
Name ST, 1. i� � r`
Name: '
Company:
�ti �
.0 �.� _ .r.. .,. ���
Address: �300 I1r2Glu1/� �yt✓......
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City: _ l�-�. PIE",�� . �'G —.^.._ State: T��
Zip Cade: 3 � �l i3 � Fax:_ _ �
Phone No.�� - Y�?r �{�'Ci
Address:! �c ��
�.oy J �,r�c�- �
City: l.a.,:� - ��
Zi p Code: �
Phone No "', c
E-Mail �l�.+x.. r'�� � C . _
State: �- i
Fax: �� `� '� 31-��5 Z
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r��tC�f �� � Ji'�it� � ' ��
E-Mail: M�iSt�£�tS6A���VGlECc�, d+�q
Fill in fee simple Title Haider on next page t if diff tterm
f,rr� m the Owner listed above SC C >?'Zit- D I �S
lJia1/I�J /�fi4STiCQs-/arc �!�/fN�f[-.�/L
State ar County License
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�irC^ �� ��rj ��
If value of construction is 250Q or more, a RECORDED Notice of Commencement is required.
If Kafue of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LfEN LAIN INFORMATION:
DESIGNEit%ENGINEER: � Not Applicable
MORTGAGE COMPANY: ____ Not Applicable
Name:
Name:
Address: .� 1 � � i
Address:
City: ��n e.� State: ��
City: State:
Zip: ��y Phone
_ .._
Zip: Phone:
FEE SIMPLE TITLE BOLDER: _Nat Applicable
Name:
BONDING COMPANY: _Not Applicable
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 na work or installation has commenced prior to the issuance of a perm it_
St. Lucie County makes na 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 Assaclatian rules, bylaws ar and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed far any restrictions which may apply.
In consideration of the granting of this requested permit, I da hereby agree that E will, in aEl respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The fallowing building permit applications are exempt from undergoing a ful! cancurrency 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 ay result in paying twice for
improvements to your property. A Notice of Commencement mus be re arded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. f you intend a obtain financing, consult
with lender or an attorne before commencin work or recur in o Mice C encement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
gnature C tractor/License older
STATE OF FtORI
COUNTY 01= .�� ��-�"�
STATE Q L ID�
COUNT1r~ tam nrt3
Swf�rn to {ar affirmed) and subscribed before me of
w rn to {or affirmed} and subscribed before me of
�/ Pig sica! Presence ar Online Notarization
this ,��*ay of (��eN�ir+�, loe..t ,, 2bZ0 by
Phy�s�ical Pres nce or Online Notarization
is � day of DucvKI3@mR , 2020 by
Name of person making statement.
Personally Known +� OR Produced Identification
Name of person making statement.
Personally Known � OR Produced Identification
Type of Identification
Type of Identification
Produced
Prod ced
{Sign ure o �iotary Publi -
wiLLIAMt.9ARTEL
Commission No. �� `�; Natar�r�pl�ij�•StateolFloriGa
Commissfan p Hk 012435
,ore4 MyCamM.fxpireslu122,2021
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DATE
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