HomeMy WebLinkAboutCMeyerPermitAppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
(Date: J-Qr%t. .f� alb ,20'A( Permit Number:
P LL 0 1 Ii l:(U k, ...,_.
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: C4'M't11'e_ cYle er
PROPOSED IMPROVEMENT LOCATION:
kddress: 697 i(,P l r rrn i.i POr4 Cfi 1 92, ? uAe- n
Property Tax I D #: 3 4 ( s -7 DOt} ( - ODU Lot No. I
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
R* R RDD-1- %406%
f ,cMo�e_ aspWf 5�;,n91�/Reptcua; w�'tk "�arr�kDlierr-%aa
G10Lc;4-r- (Vh.atG
New Electrical Meter Second Electrical Meter
I CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ W� inndows/Doors Pond
Electric _ Plumbing _ Sprinklers _ Generator " Roof ty/1� Pitch
Total Sq. Ft of Construction: 318.10 sQ Sq. Ft. of First Floor:
Cost of Construction: $ .93R36'?-Ol) Utilities: _ Sewer _ Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Ca-r i t; lG Me !,t
Name: ar0_'AA4r` \f y L(heaJ'&yL
Company: }CLfnMG��Od����QGSinl• ��nZ,�G,
Address: %%3i0 QiGKi�-SD^TGI'r'.
City: Port S+. Ll-tiC State: FL-
Zip Code: 3916-;L Fax:
Phone No. %%ol-97/-CY107
Address:3a(o ( JL
City: P/rf S1. L�t" G State: (--C-.
Zip Code: 3L49S;k Fax:
Phone No a 3q -300-9 29
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail GC hcy.mm,ert o��ol�Cc l�On'l
State or County License GGG. 1331852
11 va uc vl wnau uuwn is cave or more, a ntLunutu Notice oT 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:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
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 the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or recording our Notice of Commencement.
Signature of ner/ Lessee/Contr or as Agent or Owner
Signature of CKntractor/Licen-s-e-FrotTer
STATE OF FLORIDA k
COUNTY OF f;+. L.I_C.ze—
STATE OF FLORIDq
COUNTY OF S"�• Ly►Lo�
Sworn to (or affirmed) and subscribed before me of
al Presence or Online Notarization
Oiky of _5 Yy%wa r5 2024 by
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this QL day of J'a n tca_ror , 2024 by
�cczt,alsn �/ i t euu J P
6 Ca^A n r c,"J a✓
Name of person making statement.
Name of person making statement.
Personally Known X OR Produced Identification
Personally Known )— OR Produced Identification
Type of Identification
Type of Identification
Produced %t' _,
Produced
(Signature of Notary Public- State a) ma 'co
o� NOTARY PUBLIC
Commission No. GG/(is/3a'�, TATE OF FLORIDA
psi ' ��� Comm# GG165138
NGE 19 Expires 12/4/2021
(Signature of Notary Public- State off i ) Gina Delmedico
Commission No. GG I (vSl3g aP NOTARY
OF FLORIDA
`2 Comm# GG165138
141%
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.