HomeMy WebLinkAboutNorris permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: 1 Permit Number:
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1 L ol h. L-b Li Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Residential i(I
PROPOSED IMPROVEMENT LOCATION:
Address: iL(i s� C<;v �. L(Y'`?,�
Property Tax ID#l: LlLilt,,- -6r,3 -- adz-% boo Lot No.
Site Plan Name: W ' 5��e � Block No.
9
Project Name: 11�jo, f:c�
I DETAILED DESCRIPTION OF WORK: I
ice4-
r] N
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
0or
3 .-
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank Gas Piping _ Shutters k Windows/Doors Pond
— Electric _ Plumbing _ Sprinklers __.. Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ O j Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameX'AJ.- . avt �� o t ri S
Name: C��+i
Company: C_L! �
_
Address: I Lo7_ _00 &'jcnc��
City: State: izL.
Zip Code: LS `� `� Fax:
Phone No.6,03 "' 5-q ' -` & 3 2-a
Address:3 2-3 i S0
City: S'r`v C l_r+ StateE-'�
Zip £ode: `"{ 7cl '7 Fax:
Phone No
E-Mail:
Fill in fee simple Title Holder on next page { if different
from the Owner listed above)
E-Mail I YXA�)
bJ • 1 S
State or County License
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
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: T Not Applicable
Name:
BONDING COMPANY: Not Applicable
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.
1 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 lender or an attornev before commencing work or recordine vour Notice of Commencement.
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORI A
COUNTY OF
COUNTY OF ^
Sworn to (or affirmed) and subscribed before me of
Swa n to (or affirmed) and subscribed before me of
'
Physical Presence o Online Notarization
this Z�day of A 0 I'd , 2024 by
sical Presence r Online Notarization
this day of _ 2021 by
r+4S '.'�,
F'
Name of person making statement.
Name of person making statement.
Personally Known Vl� OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
ipw
Produced
JOSEPH
(Signa ure of Notary P zc- a. ob�I NtlisfpN GG274212
{Sig atur NotZc�� dS10N#GG274212
EXPIRES: November25,2022
ES. November 25, 2022
Commission No.IL, Oartdad1�rPabkUndxri km
Commission No.vA( �N&Vndmdem
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTI_E
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 576/20