HomeMy WebLinkAboutAtlantis 708A Bldg Permit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: --' 3 1 oa Permit Number:
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Building pp 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:
PROPOSED IMPROVEMENT LOCATION:
� i� >t� ���Address: Tp '?
Property Tax ID #: 0 ow( --- L) aLot No.
Site Plan Name: Block No.
Project Name: �-y-Iy kh+fs
DETAILED DESCRIPTION OF WORK:
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New Electrical Meter Second Electrical Meter q
CONSTRUCTION INFORMATION
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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: Sq. Ft. of First Floor:
Cost of Construction. $ %¢ 000 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name A: (La"i 1 IYI&Y14 Ann
LAwNJ" 1 to
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Name:
Address: 101 ba i.)C,PCA F, Div-
4 -? R
Company: Lau y
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City: � ,e�� i� 1 C��t(,.L
Zip Code: ,��f �I'~, 7 Fax:_77
Phone No. ^2 %g -Gl+/ /a�
Stater
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Address: J33b SL Ock r, AlVel
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City: �i tdt r`�"
Zip Code: Fax:
Phone No --n
State:_
E-Mail: Ii 5�t _ 1" tit 1 �7�.Q n h(�A �oi1 i f1(1 ��"
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail OLI) w. I lade.., t
P
State or County License t)a
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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.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: I
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: df �,�,>>> ✓1f�ke Name:
Address: A1,,1W 5Y6 Address:
City: L"( "'- State: t::- - City: State:
Zip: ,��I Phone 3d) q 3 Nq Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
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 lender or an attornev before commencina work or recording our Notice of Commencement.
Signature of Owner Lessee/Contractor as. Agent for Owner `
Signature of Contractor/License Holder
STATE OF FLORIDA
1
STATE OF FLORIDA
COUNTY OF )�tvr'I ,
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
--'Physical Presence or Online Notarization
--'Physical Presence or Online Notarization
this �'�day of 1,04i� 202� by
this day of in1�Li 202 J by
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 FL Q\—
Produced EL C
(Signature of No ' b ic- -t to of Florida)
(Signature of Not F
vie Notary Public Florida
Commission No. Wats� ��
�+NY' Notary Public Sttp�te of Florida
Commission No. Gin er Watsc4Seal)
r
y� My Commission GG 252160
@ate Expires 08/23/2022
'y� �. �aMy Commission GG 252160
7'p��d" Expires 06/23/2022
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20