HomeMy WebLinkAboutSLC Permit App TCIAAll APPLICABLEINFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3 31/d'/ Permit Number:
p � a a ,� . Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial 1y Residential
2300 Virginia Avenue, Fort Pierce FL 24982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address:
Property Tax ID #:
1.
Lot No.
Site Plan Name: _ "LivtaSthG. Oai Y.�iv tin 4irrw ( �iivrJQl� Block No,
Project Name: Z.54OvYvNyQ64e/ -{fir 1Yn0✓tntrn�.rFs
I���L h � � • r a s
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit- check all that apply:
_Mechanical
Electric
_Gas Tank
_Plumbing
_Gas Piping
_Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ n 9t 10. 00
_Shutters
_Windows/Doors Pond
Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height;.
f "
Name S ( I Licit I y
kTYIFt 4 z x
Name: g
Address: 2 Va' Ef, I' jbh1v% 114MCAUC.
Company: -15r
City:
Zip Code: Fax:
Phone No. �2— `i(a 2. -iI vo
State F�
Address: �-`rj
I NW �►r{
P„ p�
Clty: Ar (- .4N ucte' Stater
Zip Code: �C} 9 $(n Fax: 172-M 067.7
Phone No 7 ~i,46'y � I ( tip
E-Mail: 1
IL Q�J a l0o(pet. co.
Fill in fee simple Title Holder on next page
from the Owner listed above)
( If different
E-Maly ' fr rCpm
State or County License_- CLr (�. ri'14 $q. Z
If value of cnnctnfeinn ie lCnn........... .. r,��..e..�...._.�___..._--
.. _
—___. ..._.. ,. .,. wimnemennem;
If value of HAVC H $7500 or more, a RECORDED Notice of Commencement is required.
Il 4
IfpP1T/�LONSTRUCTION
_
)
[:fEN LAW
IF
INFORMATION:
r;
DESIGNER/ENGINEER:
Name: Cd—S I
_ Not
S r•
Applicable
.
MORTGAGE COMPANY:
Name:
C Not Applicable
Address:�p�5
h
evt gl
&AA^�1b
Address:
City: �r.f o
Zip: &ZA(> 1 Phone
State:}(
469P A/z L i IIS
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
XNot
Applicable
BONDING COMPANY:
Name: Ti�w.rr t
Not Applicable
A�e.l-Bptali (.�
Address:
Address:f3i Heil
�
City:
City: fNotnfo�yy ,
Zip: Phone. 3ar-/-2�/U
Al .
ooON
Zip: Phone:
wlvely Lury I twt.I UK Af•rluvl t: 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 theSermit holder to build the subject structure
which is in conflict with an applicable Home Owners Association rules, byllaws or an covenants that may restrict or pro lbit such
structure. Please consult w�th 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 ppaying 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
Wish lnne4er.,.
-�—
Signature of��n ess /Contractor as Agent for Owner Signature o1
STATE OPFLORIDA STATE OF
COUNTY OF S-Y, . LU f i P . COUNTY i
Swo n to (or affirmed) and subscribed before me of
Physical Pres n e or Online Notarization
thisl&tlayofYj,"LL ,2020 by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
L
of Florid
tNt55
Notary Assn,
Swo to (or affi
rmed) and subscribed before me of
sPh Ical Presence or Online Notarization
thi\_ayof 2020 by
Name of person making sta ment. /
Personally Known OR Produced Identification
Type of Identification
of Notary
No.
REVIEWS I CO LATER I REVIEW I SREVIEW R I REVIEW I VREV EW N (S REVIEWLE REVIEW