HomeMy WebLinkAboutHeaton PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: C)6 I I� ( I aOS t Permit Number:
O
J 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: L;nn * MIA. Necv�m
PROPOSED IMPROVEMENT LOCATION:
Address
Property Tax ID #: ya3- &y0 & - OIV 'q Lot No._J q_
Site Plan Name: 1 Block No.
Project Name: 4eck+pn
DETAILED DESCRIPTION OF WORK:
T 1 kit fN(A . nP l.J IAA n 'P r Wl 11 i A ( V'' D\nr 1 cv.. C_�C`��!-i n(a A
New Electrical Meter Y— 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 _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ R - LIDO
Sq. Ft. of First Floor: _
Utilities: —Sewer —Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name bylr) t ft lea HeG.40()
Name:_ fyo. c% S V. c7c Csu o
Company: FV OA&CLno EiCC.Agcht Cbh1- au4V
Address: 9D14 '&aCV-SOA WW
City: i=.Pierce- State: PL
Zip Code: ,39 qH q Fax:
Phone No. _4R9 - 94(a(0
Address: tkWk QkA L)I)C,Q_ &x4
City:ye t!O smCh StaterGT
Zip Code: 3aG (9U Fax:54ol"5(a4 - 9 1
Phone No =F1a_JS0_ 13u
E-Mail %ewe -C+50 co-s ey eew, c- • COMA
E-Mail: N/Pr
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License EC0oo9oa3
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 LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: _VNot 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.
Sign at a of Owner/ Lessee/Contractor as Agent for Owner
Signatur of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF 1AO f�Ivcg
STATE OF FLORIDA
COUNTY OF 'NDIfh,'-J �
Sworn to (or affirmed) and subscribed before me of
►Physical Presence or Online Notarization
this i 5r day of 7tthe, 2028• by
Swor o (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this I's'I" day of 202C by
ac�al
Name of person making statement.
Name of person making statement.
AN "&'' . �7�aH N BOYLES
Personally Known ��d g, vNeIVR gga
Type of Identification Commission r cc 956279
Pr ed My Comm. Expires Feb 6, 2024
through National Notary Assn.
Personally Known OR Produced Identification
Type of Identification
p d Ce
(i nature of Notary ublic State of Florida)
G+
Commission No. �G . l,5li o 7-9 (Seal)
Signature of Nota ublic- I�(j Public State of Florida
Commission k GG 956279
1�0 0.
Commission No. MY J@llf xpires Feb 6, 2024
Bonded through National Notary Assn.
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20