HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number: a 1 0`"i O9+5
J I LL
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial )C Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1S78
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: `\ `i 5 O S . OC.k-mn 61r. __"� � loCO� :�,e� 6Q.Gc�\
Property Tax ID#: LISOct - LPO1 - 0kS3 - 000 -S Lot No.
Site Plan Name: Solo Mon Block No.
Project Name: SolowNOYl
DETAILED DESCRIPTION OF WORK:
yj%r%aow -a OpeN%n $ — Wo1J :ryYN0 c_V mod,
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 c� Windows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 3aa 8 . m
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name. .Soloman, (jov1
Name: "ckae k Goodw►vi
Address: CkSSo S owak% or-. --A ueo9
Company: PAL4 C-Ory "Uc*inc LLr-
City: ;T&NWA-% &act State: C-L
Zip Code: 3ygS"1 Fax:
Phone No. 5091 - CHOI - -I % o1
Address: %IASo SG cyo►wa,nck A-e.
City: Qof+ E* Lvc t2 State: rL
Zip Code: 3`IRS7A Fax:
Phone No -I-)d - HI 8 - 05(oO
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail M L(-n L L,G @ pyAoc'i MA ( . Cx>VY%
State or County License G 4G 1 S 115 $ to
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: #41a * • &�v&, "C-
_
Name:
Address: A4Anr
/* ZY 0
Address:
City: A-Af Ak
State:
City: State:
Zip: Phone
13 - ?7Li( -
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
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 a other non-residential use
WARNING TO OWNER: Your fail a to Record a Notice of Commenceme/tmre It in paying twice for
improvements to yo r p o rty. A Notice of Commencemente ordedin the public records of St.
Lucie County and p steP 0 the jobsite before the first inspe l ntend to obtain financing, consult
with Iendk(r7orAan tonne before commencing work or rec r otce of Commencement.
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Signat re o Owner/ L s /Contractor assent for Owner
---- -
Signature of on ctor/License Holder
,.
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF SiLLA cif-
COUNTY OF S�• L�nc�2
to (or affirmed) and subscribed before me of
Swo to (or affirmed) and subscribed before me of
7Swo
Physical Presence or Online Notarization
Physical Presence or Online Notarization
this ]2i%ay of AP'l I .202Tby
a0aa
this � day of ZG2& b/V�,p�
� God�.(vvi11
cam% U
rn;C\_VA� GO-G6I 0
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced Dh Cet%,
( nature of otary Pu
c-, ,of Floridg LIERICHTER
ignature of otary Publi
; r�`•►"Y °Yak ; CALLIE RICHTER
MY COMMISSION # GG 319533
Commission No66631�iS3
"s'• off: IRg.S:Apri121,2023
Commission No{631 S33
t• :�: M1'�QM�lI�SIONa#GG3i9533
''•.�pd �•' Bonded ThnJ Notary Pubic Undembrs
EXPIRES: April 21, 2023
kod °P Bonded Thru Notary Public Undemfters
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20