HomeMy WebLinkAboutApplication_PoggiorealeAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: l I Z� I -L I Permit Number:
`1: L L! C I I
P 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: L-tr? ,�� L ✓&A&— Ln U-t r-J- 5tL v cr t e
Property Tax ID #: �y I / — 53() —DU q-(o — OL o --7 Lot No.
Site Plan Name: Block No. S Z
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Project Name:y6 a i O rJi -7
DETAILED DESCRIPTION OF WORK:
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— cl "4' `tip lL U
L. 10U(O-(1/0 2-
New Electrical Meter IJ I A- Second Electrical Meter AJ ME
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 _ Generator Roof Pitch
Total Sq. Ft of Construction: Z-9 (01 Sq. Ft. of First Floor:
Cost of Construction: $ 1,11/ (p . / Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE: � CONTRACTOR:
Name C o r o/ .r
44
Name: ._.)v h n aj'hU>n b SS >r �
Company:_ o S�-e / J120� fir, .-��, 'Sy jug
Address: `fig S G (/Irc_� G._ L
City: i Sf Lu c,, -e- State: RL
Address: F &, e.
Zip Code: -1 `l G 7) Fax:
City: bt LA-w J State: FL
Phone No. 77 L 79
Zip Code: .?>Z1 Z ''f Fax:
E-Mail:SiyLJu 1ilLDa(� C'c.l} . L,UW,
Phone No
Fill in fee simple Title Holder on next page ( if different
E-Mail v r ,
from the Owner listed above)
State or ounty License �L L ! 3 3 /$ J Z
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:_
Address
City: _
Zip:
Phone
State:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
j Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:.
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
State:
Not Applicable
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 first inspection. If you intend to obtain financing, consult
with lender or an attornev before commencing work or recording your N4 e of Commencement.
Signature of Owne;(n)
Ai}4� as Agent for Owner
STATE OF FLORICOUNTYOF I US l ec -
Swornn -(or affirmed) and subscribed before me of
-� Phy ical Presence or Online Notarization
thisay of l na 2020 by
I-Ah
Name of person making statement.
Personally Known _
Type of Identification
Produced
OR Produced Identification
c
ig ture
,PublicMAj FA91"
Commissi NoExpires
=
29 �46 ��
--Nov.
Bonded Thru haron Notal
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Signature of Contracffir/License Holder
STATE OF FLORIDA
COUNTYOF ubJUStOL-
Sworn to Dr affirmed) and subscribed before me of
y$ical Presence or Online Notarization
this day of CAJ�G+� 2020 by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
ature of
Commission Nib,,;
SUPERVISOR PLANS I VEGETATION
REVIEW REVIEW REVIEW
stdewfi WAhon
Comm.#HHp�6�1481
Mtnirns: Nov.4124
SEA TURTLE I MANGROVE
REVIEW REVIEW
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