HomeMy WebLinkAboutJB.WH.ch.outAll APPLIC BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I �� Zi
Permit Number:
LupQUE
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Residential
Address: JODU . L)CCa-f-I Ut--Ti--j(0C)Z Jeflte 93 � Q/ `i
Property Tax ID #4502'�A-1-0I Wn -C?L)Q - Lot No.
Site Plan Name: Block No.
Project Name:
p
DETAILED DESCRIPTION OF WORK;
4'� ' � ' �`� - -t� it � i `i 4i t �'-ic C- "n' I 'C:< 4I_ g
1 L,
New Electrical Meter Second Electrical Meter
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: j_
Cost of Construction: $ 1 & 3"), ou
Sq. Ft. of First Floor:
Utilities: —Sewer _ Septic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name _6Ci6a YV Ct.( few"-s
Name:N�Ir+-It-\
Address: Zvq j-�,9hj
Com an �
p Y;��•t`I.s;�t/�a `�t �cs---D/I.1�%i
City: If -fie A` e State:
Zip Code: ( (� Fax:
Phone No.
Address: I537 5c- �,
City:`or L.c:C,(State:-L.
Zip Code: 3`�52_ Fax:
Phone No 17a-35-7- �. .
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
State or County LicenseL-#"G iy'?` q6s-
_-__ _- ___.__._ .. a UuKe v1 wmmencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
- -- .".`' "ice""«K: _ Not Applicable
Name:
Address:
City. State:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name: _Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City. State:
Zip: Phone:
BONDING COMPANY: Not Applicabte
Address: Name:
_
City: Address:
Zip: Phone: city.
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
structure. Please consult with your Home Owners Association and review our deed for an restrictions which may a i .
Inconsideration of the granting of this requested Y may restrict or prohibit such
Y Y work
Y
in accordance with the a di i do hereby agree that t will, in all respects, perform the work
approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurr y A 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 payingtwit
improvements to your property. A Notice of Commencement must be recorded in the public records
Lucie County and posted on th jobsite before the first inspection_ If you i tend to obtain dce for
o i
wit len r or an attorne bef a commencen work or recordingAini it ni of St
,4r><< i>* :,.. ,.r,.___.__, financing, consult
of Owner/ Lessee ntractor as Agent for Owner
f STATE OF FLORIDA
COUNTY OF j v
swn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this 2--1 day of 202 by
7 Yt kn2g
Name or person mak//statement.
Personally Known = OR Produced Identification
Type of Identification
Produced
laignature of Notary Pu
111ANE COLE
Commission No. -- Nota ub'f State otFlorida
`= coMIL # GG 961089
oFn MY Comm. Expires Mar 14, 2024
"Bonded throe h National Nola Assn,
REVIEWS FRONT ZONING, SUPERVISOR
'sATC COUNTER REVIEW REVIEW
TE
STATE OF FLORIDA
COUNTY OF S'-T
Sworn to (or affirmed) and subscribed before me of
/ Physical Presence or Online Notarization
this 2�L day of �Ja huj 202# by (Ze4
Name Dt person making statement.
Personally Known OR Produced Identification
Type of Identification —_
I iSignature of Notary Public- State of
DIANE CC
Notary Public - Sta
Commission No. j Cwnmissron q G
_ MY Comm. Expires I
Bonded through National
PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW
REVIEW
2024
Assn.