HomeMy WebLinkAboutLVJ 10851 S OCEAN DRIVE #73 PERMIT APPL All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 'J Z� Permit Number:
L:C;C
L� L �' Building 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: �O
PROPOSED IMPROVEMENT LOCATION:
Address: lU F5 1 S/ _ U �°��� .JQ�/`U C= ^�
Property Tax ID#: yS� f Y/y' �� o�V w` _ Lot No. y�
Site Plan Name: Block No.
Project Name:
rr � --
DETAILED DESCRIPTION OF WORK:
/rGC� G � t�•'f � C�L l 5<G[CL� / T� /�/tt uGv %r -i+� / OC-K
Ozye
New Electrical Meter Second Electrical Meter
-- --- - - - - -_-. ---
LCONSTRUCTION INFORMATION:
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors Pond
_Electric Z plumbing _Sprinklers _Generator _Roof _Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ ( Z Utilities: Sewer Septic Building Height:
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OWNER/ El ,
Name �- L°J ® "14E5 RT/c S G Name: Jam.eo 7—Y /tom
Address: i�r1`J f� y�2 Pdi�� L/2 Company: _90 -/,30"JL- L[.c�-N,'1QiWGi-�NG
City: tj ES-'-V/J _State:�L Address:_121 3 VU)14_5-_s �{�•�}77
Zip Code: 3 33�-� Fax: City: '5P,°v/x)y5 State:IC2_ �j
Phone No. /��'�yU' yoZ l D_ _ _ Zip Code:__�% 74 // Fax:��"� Q-15 d
E-Mail: Phone No
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) 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 I..AW !NF0RMATION-
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 post n the jobsite before the first inspection. If qu intend to obtain financing, consult
with lender or an rney before commencing work or recordin our, Notice of Commencement.
Signature of O see/Contr or as Age r Owner :ATE
natu of Contractor/ se Holder
STATE OF FLORIDA OF FLORIDA
COUNTY OF tFevwzhe a 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 ,202J'by this 5Cclay of 202P by
Dec 7
Name of person making statement. Name of person making sstatemen .
Personally Known OR Produced Identification Personally Known " OR Produced Identification
Type of Identification Type of Identifi t'
Produced nn� Produced
(Signature of Notary Pu Cf f, (Signature of N:Et e�f FIKAREL IRRGANGcEL IRCommission No. MY CIQh UIi LION#GG 974965Commission NEXPIRES;AprA 7,2024MhtISSIG EXPIRES:Apra7.20 T_WN PUWic UrxierwrAers !ed Thru Matarj Puplic V�Qe�irifers -----
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED _
Rev. 5/6/20