HomeMy WebLinkAboutBuilding Permi tAppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
AF 1D A
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Planning and Development Services
Permit Number:
Building Permit Application
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: Genes R.
i�r�o�erSOr�
PROPOSED IMPROVEMENT LOCATION:
Address: 7791 SanoebLyv Pkrf 5f M'.c IPL 3qq
Property Tax lD #: Lot No. 04
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
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New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
Block No. t
_Mechanical _ Gas Tank _ Gas Piping _ Shutters — Windows/Doors _ Pond
Electric _ Plumbing _ Sprinklers _ Generator ✓oof Pitch
Total Sq. Ft of Construction: 3 y • T.15& Sq. Ft. of First Floor:
Cost of Construction: $ 2 (1001. ii-7 Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE: I CONTRACTOR:
Name (—rK ben
Address:1PR
J
City: �- State: F(_
Zip Code: L%.Se1 Fax:
Phone No. 77a - t'p3 -9W 7a�
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: f— (�,n V (t ( Q_ Lje
Company: RCun M t,r ROCA'no +-,Q,CS /-6L�iQn L
Address:?-R& I IvA u.,t
City: Ppf'f, C.rc C. t State:-L
Zip Code: 399S.'L Fax:
Phone No 2 39 -300-9agl
E-Mail t e- 0 ;
State or County License
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:
Name:
Address:
City:
Zip: Phone
_Not Applicable MORTGAGE COMPANY: Not Applicable
State
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:_
Address:
City:
Zip:
Phone:
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
v VV IV Ln/ I-UIV I KAI.. I UK AII-IUV I I : 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 hefora rnmmanrina ," ,r4 .,r ro�. 4;.,,, ., ._ KI—:
- - - - -- -
1--I vul 1 VUI.0 VI l..V 1 LCrrlenT.
Signature of Owner/ Lessee/Contr ctor as Agent or Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF G+- Lu,Lt -r—
STATE OF FLORIDA
COUNTY S'�-. I..I,t.c.L
OF L
Sworn to (or affirmed) and subscribed before me of
Ph sical Presence or Online Notarization
S rn to (or affirmed) and subscribed before me of
f- Physical Presence
this 95ay of 202¢ by
or Online Notarization
this&Jbday of 202f by
ra'(40/' v %, �k n cow-v e—
Q ra n �otn y r ll n �u.t�. V L
Name of person making statement.
Name of person making statement.
Personally Known %/-'— OR Produced Identification
Personally Known )C OR Produced Identification
Type of Identification
Type of Identification
Produce ,,_
Produced
,,_
DeOlediCO
(Signature of Notary Public- State ofV*NOTARY
(Signature of Notary Public- State of Flor" Delmedico
GG I �s� 3� PUBLIC�Gina
Commission No. TE OF FLOR
D&GCv�W% aq Q NOTARY PUBLIC
mmission No. STATE OF FLOm#
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REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.