HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED C J )
Date: '7 t7�� Permit Number: J o7 ' / .
a RECEIVEQ
° Building Permit Application APR 30 loll
Planning and Development Services
Farmitti,19 p�epartment
Building and Code Regulation Division Commercial Residential St,tuci�ccuI
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
,j�R,®P�OSED P
Address: 167 SE Floresta Dr Port St Lucie, FL 34983
Property Tax ID#: 341953001630003 Lot No. 12
Site Plan Name: Block No. 3
Project Name: Atari
11®ETAILE® ®E�SCR;IP.TI®N ®�F U1/®RK 1y< f x
Tear off existing shingle roof and replace with a new shingle roof
New Electrical Meter Second Electrical Meter
NMICI® INFORMK T N. 6 y
N A L® �
; 1a ai,. NMI I ON' µ // f a
J
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Pond
_Electric _Plumbing _Sprinklers _Generator ✓Roof Pitch
Total Sq. Ft of Construction: 2721 Sq. Ft. of First Floor:
Cost of Construction: $ 13,500 Utilities: —Sewer _Septic Building Height:
i. „ � ,. .. yC®NTRA o !fl ll yy'
OUIINER LESSEE
x: '..,,,,.. ,. ra
Name Q 'L-&2i Name: o:� FQ14fft
Address: 107 a Company: Pe_ .4.4_ P`-J" ' L.Cd-
City: �o R i f7(� f,c, State: rl" Address:`fla
Zip Code: 3 Y f l!3 Fax: City:POAT sy. L&ccat State: 16--L
Phone No. (o / -76 - 6 3-1S Zip Code: L{Q S3 Fax:
E-Mail: i Phone No _-77a -- a 00�4
Fill in fee simple Title Holder on next page(if different E-Mail AOV p;tig Y0 Ca %-Ma- f' C Owt.
from the Owner listed above) State or County License CC 73 S I_S (o
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.
SUPPLEME !S72TIRMIMW 1010NIMMAIN�®RMATIaN.
MENIMEW li M=
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone 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 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 Cou and posted 09 th jobsite before the first inspect* f you intend to o tain financing, consult
with le er an attor e b ore commencing work or re n our Notice C mmencement.
Signature of wn r/Le a Con ractor as Agent for Owner Signature of Co trac cen a Holder
STATE OF FLORIDA STATE OF FLORIDA /
COUNTY OF f. Z GLcI COUNTY OF
Sworn or affirmed)and subscribed before me of Sworn to(ar affirmed)and subscribed before me of
Physical Presence or Online Notarization ysical Presence or Online Notarization
this day of ,fin 2020 by this day of ,2020 by
Rov IYK l-h AJ 0 V �4�e 4
Name of pe son making statement. Name of pe son making statement.
Personally Known �OR Produced Identification Personally Known Produced Identification
Type of Identification Type of Identification
Produced Produced
anA&v
(Signature of Notary Pub i (Signature of Notary Pu
iwfiJi Notary Public State of Florida Notary Public State of Florida
Commission No. Ar>�1b11�Reidy Commission No. • And
e !My ommiesion GG 347851 My Com' GG 347851
7j�w Expires aw Expires0812312023
Snew
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 5 6/20