HomeMy WebLinkAbout3432 ROSELAWN BLVD, PSL, FL. 34982 PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dater ' O J L21
Permit Number:
L�
41ro O E
0
a nWPWABuilding 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:
Address: i J. c
_ _b Lot No. 3 `�t'I
Property Tax ID#: -�
w K p45 3 AwL-l(0 5ar1-c) roR'R3- Block No.
Site Plan Name: r7 ZSQcf02 -(�4�
Project Name:
DETAILED DESCRIPTION OF WORK:
New Electrical Meter (V I r-� Second Electrical Meter__JJLLF}
CONSTRUCTION INFORMATION:
Add itionai work to be performed under this permit- check all that apply:
Mechanical — Gas Tanis —Gas Piping — Shutters Windows/Doors Pond
Sprinklers _ Electric .� Plumbing p —
Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction, $ JWto 4 C Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
Name i I '%-
Address:2 1 C,
State:
City: J C
Zip Code:tgo2 Fax:
Phone No. �ygy
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: (IJG c'r !C
Company: l r ti r ar. -
Address O ��,ri!, _^
City: + + t e State._
Zip Code: iQ 310 _ Fax:
Phone No�Z—
E-Mail r tr; l.- r� I'JP� c K K7, lures L'+er. CCVL'1
State or County License - &Y -
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,5fl0 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: City:
Zi p: Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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
trlucture.Please consult withpyou applicable
Owners Association andrreview your deed for any restrict o s whimay chtrict may applyhibit such
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 attorney before commencing work or recording our Notice of Commencement.
Signature caner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORID.�A}
COUNTY OF 5 I -it " �e, _
Sworn to (or affirmed) and subscribed before me of
Physical Presence or online Notarization
this 11— day of �!,1 202W by
JCZ,,() H 6L, ( t
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced 0
(Signature f2M.:
P Notary Public fete of tori)da
Commission d HH 49 24Commiss'lo 12ar iresGet1�01114
Bonded throuo National Not
Assn.
REVIEWS I FRONT I ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
STATE OF FLORIDA
COUNTY OF C-(
5wgrn to (or affirmed) and subscribed before me of
1 Physical Presence or Online Notarization
this day of 2020 by
4i r..
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced..
(signat' ery PulAfL4F�iLA1°a
Natery Public State of "0"'a
Commis o�,oujhKNa
HH 49824 (S I)
7�0
Ot1,2024
! Notary Assn.
SUPERVISORI PLANS VEGETATION I SEATURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW I REVIEW