HomeMy WebLinkAboutWH.Chg.out.TrentAll APPLICABLE
�INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: � 7'1'211 Permit Number:
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: i -�' -�"e�" �� yu f-
PROPO ED -1 M PROVEM ENT; LOCATfb N."=
Address: _ 6044 �-t v°`.. c-+� 4)Ir c } t` t c,c �� J 5 a
Property Tax ID #: _3-J CO9'5- COC -- (c Lot No. 12-
Site Plan Name: L-►r)V-S at S&yo r iQ64. CIL2b Block No. 3('�
Project Name:
OETAILED`DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter
CONSTRUCTI(3N II�IFORMATION:
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters
_ Electric Plumbing _ Sprinklers Generator
Total Sq. Ft of Construction:
Cost of Construction: $ i -3 9 1 9__
— Windows/Doors _ Pond
Sq. Ft. of First Floor:
— Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE,
CONTRACT�R:
Name UrULe- Linau- _rr'eln
Name:
Address:9V`e_St t>Yl i)+C
City: i �'(�{ State:L
Zip Code: 3 qQ s"z Fax:
Phone No. 214- WS - 3T3 Z_
Company:�tie
tut d- Ave -
Address:
�r
Citj6i- 5 -: C e_
Zip Code:3+{9S�a
Phone No
State: i-
Fax:-17d- p73 3!S�
2-?--
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail C I
om(..,
State or County License
.� vatuc yr L-1—i uLL,un is GJ , or more, a Kmurtutu Notice Ot LOmmencement Is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
Name:
Cites - -
Address:
City: State'
Zip:. Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:.
City:
Zip: Phone'
"iWINFR/fY11tIT'narreto wr.-er.�rer_ .
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address.
City:
Zip: Phone:
---- - • -.•- .-.. •� r+i+N�rauon fs nereuy maae 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 exemptfrom 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
witen, r or an attorney befdte commencing work or recordinumntir Nn&ira of inrrfe�rSArn.Y.r...t
of Owner/ Lessee ntractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF -;r
swo n to (or affirmed) and subscribed before me of
P ysical Pres nce or Online Notarization
this dayof 202# by
Name of person makingt.
statemen
/
Personally KnownZ _ OR Produced Identification
Type of identification
Produced
(Signature of Notary Pu
Y . s
PANE COLS
Commission No. Nola State of Florida
C= # G5 961089
'`• My Comm. Expires Afar 14, 2024
STATE OF FLORIDA
COUNTY OF si {� � e,
Sworn to for affirmed) and subscribed before me of
P-" P sical Presence or Online Notarization
this day of 202# by
Name of person making statement.
Personally Known OR Produced identification
Type of Identification
Signature of Notary Public -state of D"E cc
ES :_
Notary Public - Sta
Commission No.G
flwMY Comm. Expires I
�ded #wwgh Natrona)
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lerr
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