HomeMy WebLinkAboutPermit App - 206 NE Lobster RdAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 0.� - 02 - dbJJ -Permit Number:
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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:
Address: 6�
Property Tax ID#:3LIso0-Io13-000-a Lot No. 17
Site Plan Name: Block No. 43
Project Name: T _�l t,(r(ll'VVj AM01ti CPA,
New Electrical Meter Second Electrical Meter
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 �I �a� Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ R,5go•0n Utilities: _Sewer _Septic Building Height: �a
Name
Name:_ okU,UoyyQ
Address: coIJ E
_yvanrvi
Company: r
City: VA , 9, JAAAA State:
Address: 11-10 [jyr
0jn ylngX -$[id( A Na0
_
Zip Code: ?pj q L Fax:
City: C4 QVIbit LykK, State: FL -
Phone No. 1�4d2 - 941 - 805
Zip Code: _2,s0(_3 Fax:
E-Mail:
Phone No3(91-50(—8gr -
Fill in fee simple Title Holder on next page ( if different
E-Mail '?
State or County License 133
from the Owner listed above)
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.
DESIGNER/ENGINEER: _ Not Applicable T MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 attornev before commencing work or recordine vour Notice of Commencement.
Signature of 0 n r/ Lessee/Contractor as Agent for Owner
4ignature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF A kAzia
COUNTY OF A a2i.(.f,(L
Sworn to (or affirmed) and subscribed before me of
Swofn to (or affirmed) and
subscribed before me of
Physical Presence or Online Notarization
✓ Physical Presence or
Online Notarization
this cZ day of O A(AQ�202Q by
this _cL day of
2021 by
Name of person m king statement.
Name of person making statement.'
Personally Known _V OR Produced Identification
Personally Known V
OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signatur otary P F Vio@CII�GG248882
(Signature of Not ry Publ'
•v....L.9••,.,, HUNTER SHAN
di?•• '•�F•:,
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ro; EXPIRES•AUgUet15,2022
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Commission No. i Ft:3"•'` BowedPWGCUn MY0111s
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Commission No.
- ;.: MY862 ION#GG248
P E IRES•August15,2022
Bowed ThN Notay Pudic urci shm
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.5/b/20