HomeMy WebLinkAboutKellaway Pemit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number:
Building Permit Application
Planning and Development Services
Building and Cade Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 fax: (772) 452-1578
PERMIT APPLICATION FOR:
Commercial Residential
� PROPOSED IMPROVEMENT LOCATION:
Address:J.Q�11 ci S fYorin l�iZ- i�fa)� Ut�`5 �h5inea��ti ,�'�IiYS�
Property Tax ID #:
qs-tl- Sty -ice.
, 000'_":�
Lot Igo.
Site Plan me: Block No.
Project Name:
r
DETAILED DESCRIPTION OF WORK:,
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
Mechanical
Electric
a Tan
Plumbing
Total Sq., Ft of Construction:
Cosh of Construction: $ 1 1 quo
Gas Piping
Sprinklers
Shutters
Generator
.Windows/Doors Pond
Roof Pitch
Sq. Ft. of First Floor:
Utilities-. Sewer Septic Building eight:
OWNER/LESSEE: TCONRACTOR.
Nang e__ Name* Via, ,
Address: Company-
CityT
State: Address: i
Zip Code: Fax: A11P City*. �ZState.
Phone No. i�-v -s- Zip Code: Fax: 7i-w!-'
E-Mail....— Phone ��If 1 14
1P
Fill I in fee simple Title Holder on next page (if"s '?'; � d L� Lj? kizz i
from the Owner listed above) a"e r County License � ." Ll,
If value of construction 'is 2500 or more., a RECORDED Notice of Corn mencementis required.
If value of HAVC is $7*500 or more., a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION Ll.--E.-N LAW INFORMATION;
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY:
Name: C&d*-
Address:
ityat
Z*1 P:
i �
-L-,�
ii t X
Phone
Stater
FEE SIMPLE TITLE MOLDER: �'Not Applicable
Name:
Address:
City,
ip: Phonel.0
' Not Applicable
Name:
Address:
City: State:
Zip; Phone:
BONDING COMPANY: Not Applicable
Name.
Address-.
city....4h
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and 'Installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
5t. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
Which �s in c�n�lict with any appficabl� Home Owners AssacEation rubs, bylaws or a�►d covenants that may restrict or prof�ibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, i do hereby agree that I will, in all respects, perform the work
i n accord once with the a p proved pi n , the Florida B uiIdi rig Codes a rid St. Li de Cou nty Amend menu#
The following building permit applications are exempt from undergoing a full concurrenc preview; room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WAR N I N G TO OW N E R: Your failure to Record a Nofice of Commencement may result i n paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Luce County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with fender or an attornev before commencinE work or recordine your Native of Commencement.
STATE OF FLORIDA
COUNTY OF
Sw rn to (or affirmed) and suf�$cribed before me of
�Physical presence or online Notarization
this 14,1-& day of Al&/�N , 2024 by
Name of person making statement{
Personally Known Produced Identification
Type of Identification
Prod uced
A
Personally Known � Produced Identification