HomeMy WebLinkAbout2901 Industrial Ave 2All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Planning and Development Services
Permit Number:
Building Permit Application
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: J' ic,i -! i1cA�ir , cc I C %.�c 2 f-V r- cti L 3qG 4
Property Tax ID #:
Lot No,
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
_Mechanical
,Electric
Gas Tank
Plumbing
Total Sq. Ft of Construction-
— Gas Piping
_ Sprinklers
Cost of Construction: $ 4&L.p�
OWNER/LESSEE:
Shutters
Generator
Sq. Ft. of First Floor:
Block No.
r
Windows/Doors Pond
— Roof Pitch
Utilities: _ Sewer ` Septic
Name Lilrlr7 Tr1Ctl AU+?ll�le LLC —
Address: (veto Id 17. C ),t bW(tc (,-
City: L 4' Li, A State: FL
Zip Code: _Fax:
i Phone No.-71)7lb- 14 16,
E-Mail:_MO1MT./, VSCre. Oom
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name:
Building Height:
11 Company:efaliLg�i [r
Address: 81AJU
City: State:_/Ly
Zip Code: Fax:
Phone No�2t-/"
E-Mail_/eC 2-A) VWo4,L, Caw
State or County License s -
If value of constructiorl 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.
3VrrtxnntN I AL LONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINE
Name:
Address:
City:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
— Not Applicable
State:
— Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City' State:
Zip: — Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
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 Horne 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 anla me before Commencingwork or recordin ou otice of Commencement.
Signature of Owner/ Lessee/Cant actor as Age7A for Owner Signatur of Contractor
nse Holder
STATE OF FLORIDA,- i
STATE OF FLORIDA " COUNTY OF /�Lq'itT� /�/�-�' COUNTY OF ,ct� dr-�-rt
Swo to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this ! day of 2029 by.j[L_
Name of person making statement.
Personal) Known
Type of Identification
Produc�
(Signature of No
Commission No. 40
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
OR Produced Identification
Moj ilublic St��r of FW4@
Jessica K.erldrick
my Comm+tsion W623
10121 3
Swor o (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this ^ day of 2020 by
t��&-ey lev4vr
Name of person malting statement
Personal) OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida
a5*RY.pue� ASHLEY HELMS
CommissionU�7=
GG352735(Seal)
sl2.2023
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