HomeMy WebLinkAboutmaster permit_000656All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3' 3' Zo 2 ) Permit Number:
L1cll'
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:
PROPOSED IMPROVEMENT LOCATION'
Address: '� Ci
Property Tax ID #: y 70 - Z Lot No.
Site Plan Name: Se-1, a CTe /� Block No.
Project Name: $��, et. GT%C gt='JJ emfe
DETAILED DESCRIPTION OF WORK:
Rc owye gr, Atcl
J.0/// 46V e.
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
Electric _ Plumbing _ Sprinklers _ Generator
I
Windows/Doors _ Pond
Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ ,�, c206 .
CID Utilities: Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name me rYwALc C- ea. Sc_%uGTC-
Name: Ck dTess
Address: i
Company:
Address: G% ape
City: State: ,P—
Zip Code: 3�i�i�a Fax: 6&-J! '
Phone No. yOH- (63 - G%yy
City: i 6 Stater
Zip Code: 3340"1 Fax:_S61-8141 - /bU
Phone No-6r./- 6111-1.6 K
E-Mail: u G/
Fill in fee simple Title Holde n next page (if different
from the Owner listed above)
E-Mail //iiFt A ��,4WS�� GOM
State or County License 015Y$.6—
If value of construction is 2500 or more, a RECORDED Notice of Commencement is requires.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
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:
Zip: Phone:
City:
Zip: Phone:
JI. .. .A : +-.II,*inn — i—lirmfoH
OWNER/ CONTRACTOR AFFIDVf1: Application is nereoy macu
e to oota, a NCIIIIIL <U UO LIM . � a„w ,"�•�••�••�•• �- ••• •_____.
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
structure. Pleasie consult any applicable
Owners Association andrreview your deed for any restrithat
t ons which may apply prohibit such
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 recor din the public records of St.
Lucie County and posted on the jobsite before the first inspeclim ino obtain financing, consult
..:aL. I.....J.....r -... �++r.r..o.� knfnrc rnmmcnrina wnrle nr rPFnr ln� o r No Commencement.
WILII IC"UU! VI 0" a«via. —
— ---- - -
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of ontrac 'cel se Holder
STATE OF FLORID -
�SYI '�
STATE OF FLORIDA �ECle�
COUNTY OF PQ�17�
COUNTY OF C,
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
>' Physical Presence or Online Notarization
X Physical Presence or Online Notarization
this q day of OAK t , 202Cr by
this 2l day of 0)i-\ I C) 202e by
Pa�r1C�C�
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known X OR Produced Identification
Type of Identifcation
Type of Identification
Produced �L �7 L
Produced
Joy
(Signature of Notary Public- State of Florida
Signature of Notary Public- State of Florida )
Commission No. t10 3L SMe 'COMMISSIONHH3678
ommission No. ��) Q (Se
�1pEAN HIBL
EXPIRES: September 19, 202
MY COMMI78(
SSIOl ber 202
oFa
19,
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
or a
SEA U LE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20