HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: D0-1 Q 3'-01JOa l Permit Number:
J
w
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Port Pierce FL 34982
Phone: (772)462-1553 Fax:1772)462-1578 Commercial Residential
PERMIT TYPE: .qf c CA I e 0 U l HvlqC
PROPOSED IMPROVEMENT LOCATION:
Address: 3311 I ronwoocl Ave Por+ Sf Luc Ie FL 3 a.
Property Tax ID#: '3 qa5— D„3-D360-O'D1_D-3 Lot No. 9
Site Plan Name: Sav"(\Q. C Iv b P taf `4-wee Block No._3 ?
Project Name: C ha.hocN esidp-n('le,
DETAILED DESCRIPTION OF WORK:
—Re,meo-e, L�ktx-b;iA Arviarn&z f 44 aSCArd,
l 7
rui p 14 PA4{2 N A6 g a000AA:r P. Se i'dl F.67S�1.201.
[CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
XMechanical _Gas Tank _Gas Piping. _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers —Generator _Roof Pitch
Total Sq.Ft of Construction:/! Sq. Ft.of First Floor:
Cost of Construction:$ �y d� ac�c Utilities: _Sewer e Septic Building Height:
OWNER/LESSEE:..' y. CONTRACTOR:
Name Name: TAM CS L, (�//{11)I LG/A K-S
Address: 3377 �ro(1� ` 0f, Company: A&a�- /4/1/Tt(- /1�4LRa 41 e,- 11i�
City: State:FL Address:QQ�—, AZ P, lznA lhSf .�&&
Zip Code: Fax: City: (gar¢ s'f, Lac i e. State: Fz—
Phone No.._OL-1 930 Zip Code: 3�19? Fax:
E-Mail:O -�c'l 'C2r_^ ��o��G 1.eDf�1 Phone No -7j,1- 6.2/- 76S-0
Fill in fee simple Title Holder on next page{if different E-MailQ,4qGee,!e a&m0../1a XrC1- eD m
from the Owner listed above) State or County License
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTS N LIEN LAW INFORMATION:
DESIGNERIENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name,
Address: Address:
City: State: City: State:
Zip: Phone 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 accessary uses to another non-residential use
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYIN�
TWICE FOR IMPRO-fEMENTS TO YOUR PROPERTY_ A NOTICE OF COMMENCEMENT MST DE RECORDED AD
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LPMDW OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT--
�r
Signature o w essee/Contr or as Agent for Owner a afore of t or/Li s er
STATE OF LORIDA - STATE OF FLORIDA
COUNTY COUNTY OE s 7- LUG i e,
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this�_day of i 2t� by this-day of 0.f 20 2/ by
O�� A\.o 7ra N P,—(:� I— I W ( tl �&_V�,S
Name of person making statement. Name of person making stat ment.
Personally Know PRE PJe`AI�Prc �� i Personally Known_ �lcedA #ttici_
�: �� otar i - a i ,_
Type of Identific *_ Commission # GG 966362 Type of Identification =* "= of
Public-State of Florida
*= Cc�nmission #GG 966362
Produced P Iv1v Commission Expires Produced " bmmissian Ex'rrriir"` February 09, 2024 "a,rr`"� Fbruary 0g, 2024res
(Signature of Notary Public-Sta lorida} (Signature of Notary Public-StUAf Florida)
Commission No.QC
qq,4;:44 Q_ (Seal) Commission No.66 CVO(0,'-Za (Seal) _
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 1