HomeMy WebLinkAboutApplication_HouseAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: J I J/ Q Permit Number:
.;d�
`3
L Building Permit Application
Planning and Development Services ' '
Commercial Residential
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR':'k_
PROPOSED IMPROVEMENT LOCATION:
Address: '52/3 A )mrniaczhir-d /,doGj 3iA
fliff7e� EL 39'551
Property Tax ID #: J 50/ -bOo? -(xjC% �"� — d / 0 - / 'Lot No. �8
Site Plan Name: Block No. /02
Project Name: /lo 05C Root
DETAILED DESCRIPTION OF1lORK:'
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�E�GI( urt Sh��Q (� 1fLSlu� ftG'wShi,Z�� �,✓ .Q�nS �rrnna 51-,1 ��,C.��
_
UU 4L j izu UYV -1-)r , I V, , 4rcJ,-) rL 7 u u (v I�i� �► �-'L is Z i t� 1'� S�
New Electrical Meter L�4 Second Electrical Meter tJ
CONSTRUCTION INFORMATION: 4)"
T
Additional work to be performed under this permit — check all that apply:
_Mechanical Tank, _ Gas Piping _ Shutters _ Windows/Doors _ Pond
_wGAs
_ Electric _Plumbing _ Sprinklers _ Generator _ Roof (o 1a Pitch
Total Sq. Ft/of Construction: ,?GI.070 Sq. Ft. of First Floor:
Cost of Construction: $ /(�, 18 3 35- Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Larry %us _
Address: ,5 3 HID mr»112,6'-d- WC4
Company: R.vSSC- (Lc4e1-J Soiu�
City: �FbY4 Fier-ce State: -FL
Address: _�501 SVJ EedeeLd f} N;►J S�_,k 9WC.
Zip Code: 3`1`151 Fax:
City: 5_-hzW+ State:FL
Phone No. .? -?a 35r7 - L49 L06
Zip Code: '3�- cKlq Fax:
E-Mail:MhaAe_y1CaPm:e-u n
Phone No Lo -(90)(o-;;1Y1(o
Fill in fee simple Title Holder on ne,gpage ( if different
E-MaiI (1r (+SO VUs5ervai✓t4. C.tarYf
i
State or County License CCC 133 i ,gl of
from the Owner listed above) ti ' , ��
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 CON!
DESIGNER/ENGINEER:
Name:
Address:.
City:.
Zip:
Phone_
Not Applicable
MORTGAGY,COMPANY: 4ot Applicable
Name:
Address:
City; _- State:
Zip: -- Phone:
FEE SIMPLE TITLE HOLDER: iNot'Appllcable BONDING COMPANY: Nat Applicable
Name, Norne:
,Address,: a _ Address: _
City:- —� Clay:
Zip; _ --- _ Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application Is hereby made to obtain a permll to do thtr wend Installation its indlcatr�d,
i certify that no work o; installation has commenced prior to the issuance of a permlt, '`
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-residentiol•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.
LL ie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attornev before commencine work or recordinp- vour Notice of Commencement.
�gnature of Owner/,Lessee/Contractor as Agent for Owner
is
STATE OF FLORID�-
COUNTY OF Y,t.t�� (,�lQ_
Svyorn to (or affirmed) and subscribed before me of
V Physical Presence or Online Notarization
this J,Q day of AbVPymIoPY , 2020 by
ame of person making statement,
Personally Known
Type of'Identification
Produced
.(Signature of Not
Commission No.
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
ev.
OR Produced Identification
ontractor/License Holder
j6TATE OF FLORIDA ,.
COUNTY OF SCctrA-(A.(ae
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this JQ_ day of,
AA[��n►k1.b mbee , , 2020 by
Name of person making statement
Personally Known `� OR Produced Identlflcatlgn
Type of Identification
Produced •
ar�Pylt�lic 5t3ti luf,t•4;i )i�NICLLi. MAI, i Gf fJ6j�,�iA
(/ Y r I
f, ,,a Notary PuUhc-Stor1.1 c I IcrP I
ror''miselon N HIA t,,t� 8"15
)My Commiar�ion I:xt,Rll?n�i
FRONT ZONING SUPERVISOR PLANS
COUNTER REVIEW REVIEW REVIEW
/of No, _ Lib � � St, e�
"a� ANIELLE MARIE GONE
oil No.1ofp�,y r'L,bric.5tste of I 1
HFhmiss�on p HH 6 E
My Conimission Exp r
"OvOO'bMr 01,-20214
VEGETATION SEA W11 fLl MANGROVE
REVIEW REVIEW REVIEW