HomeMy WebLinkAboutMann Permit Appm ai"1n
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1SS3 Fax: (772) 462-1578
PERMIT APPLICATION FOR;
PROPOSED IMPROVEMENT LOCATION: to 1
Address:
Property Tax ID # � 3U1 • (DC7�- ' pZ 2 0 • coo ' V Lot No.1-1 18
Site Plan Name: Block No. -16
Project Name: N Y1ri QLQb4
f DETAILED DESCRIPTION OF WORK:
. „ fl4al I Alt 4-130
New Electrical Meter Second Electrical Meter %_�1W%_X' "1kJ Y"r=&il Jv
al f 2•Xj-� 4O co C��
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical ^Gas Tank _Gas Piping _Shutters _Windows/Doors Pond
Electric _ Plumbing — Sprinklers
Total Sq. Ft of Construction: 2,13�
Cost of Construction: $ 12 / 6bO
— Generator Roof -'q Pitch
Sq. Ft. of First Floor:
Utilities: _• Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name nnYYiV_ N1�
Name: On4jron !�U
Address:��--W0 �P14YU $ V
Compan a
City: _ -t�G rcc State:
Address: S
SEy"
Zip Code: Fax:
City: �_L5M
l LLC'L'G
Stater
Phone No TI2.+44 041,54
Zip Code: sa52- Fax:
Phone N642Z CO2I Co 2CP
E-Mail:
Fill in fee simple Title Holder on next page ( if different
E-Mail � s `
from the Owner listed above)
State or County License '0
240I-
IT value or construction Is 25ou 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:
— Not Applica
Name:_
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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 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
with lendd r_or an attorney before commencing work or recording vour Notice of Commencement,
ature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA '6 , -
COUNTY OF c UISIC
Swor (or affirmed) and subscribed before me of
Ph ' al Pres, nce r Online Notarization
this day of , 202f by
Name of person making statement.
Personally Known OR Produced Identification
Type-ekdentificaX'K
rnrli ira
re of Contractor/License Holder
STATE OF FLORIDA �'
COUNTY OF-
4 affirme ) and subscribed before me of
l Prese c r `7�L A Online Notarization
of )mn by
vim cuer
Name person ma ng statem
Personally Known OR Produced Identification
Type of Identification
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Produced
isignature-ot Nota (Signature - Ssta 4„5rid r'09
Wy Public SUM d Florid@ (�j 0 1 � ( 0? dyr � � .
Commission Na. a ele JofM OW70 Commission 'p�oF�'°►ued .
c.. Comm�i�?l RNM1oN
a v► Expires 05/15/2024 . ya s►nS al d
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
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