HomeMy WebLinkAboutPERMIT APP7007 GEORGE RDAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
DatePermit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPR^/O�VEMENT LOCATION:
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Address: - %00 e
ff ��,,/
Property Tax ID #: l3o i _ b Y — tofu C) C)6 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
f0 C) Ri
J rn �o
New Electrical Meter Second Electrical Meter
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 _Generator _YRoof 51 / Pitch
Total Sq. Ft of Construction: 1 N2Sq. Ft. of First Floor:
Cost of Construction: $ 1 00 000 Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRA TOR:
Name f/
Name:
AdreU; ��4�(r�S
Company: /'eq Sf//G met
City:'7 State: L
Address:
City: I} State:,
Zip Cade: c / Fax:
Phone No. 7 7a— GPIh - SowY
Zip Code: 3u45!�H Fax:
E-Mail:
Phone No .�' �177
Fill in fee simple Title Holder on next page ( if different
E-Mail C Aae Go r-ON,
State or County License /
from the Owner listed above)
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.
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 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.
t0
Signature of Ow erUsee/Cmractor as
gen
er
Signature of Con ractor icense olderSTATE
OF
STATE OF FLORIDA ° o r
COUNTY OF C •
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COUNTY OF (/C m c�
re
ta��t
Sworn to (or affirmed) and subscribed bef
Physical Presen e or Online N
x d
Sw rn to (or affirmed) and subscribed before a CS c c
Physical
Presenceor Online Notar' at7n o a
this day of _/!�, 20
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E
this ` day of , 2020 b '� E
Gr1 Gl O
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Name of person making statement.
Name of person making statement.
Personally Known '�/,—OR Produced I e on
Personally Known `3t OR Produced Iden i
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary ic- State of o a)
(Signature of Notary Publ fate of Flo )
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
I
COMPLETED
Rev.5/6/20