HomeMy WebLinkAboutPERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
DatetIs
.01MON - am% - _ . - _ . _ .. _
[F7
Planning and Development Services
Permit Number:
Building Permit Application
Buflding and Code Regulation Divfsfon Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone@(772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: )LOBO�
PropertV Tax I D #U19
Site Plan Name: K.
7 a ��� I - W 11 11111 -
aS-�OS-b0
cc�y R�tcck
DETAILED DESCRIPTION OF WORK
1
Residential K
.. - - rL �a T7�'a_1' � ' + .'� _■�.-ice ' _ J ' bL
Lot Noo_^
UffR%1mk No.
r r _
i .+r+�•{�{��i=i: ����i•■r'��? ��•`_#■�� f1� it y: y :�k, ' ' Y i � � � ' : _ � �. i _ _� _ ,. y •1 _ _
_ Y i `r�� {• �3 'f- ' ■•�'� rT. _•S }'y{ ��',i :+ .;+i'-}�_f�i' .� 1 •it•, F�� �'■'_ '� ,ti. `'O +r 'if' i .,r_*Y _ -■F�. hi•J f.
New Electrical Meter Second Electrical Meter
ia��'i..�� - - r �� J'- r�'. .r - �• }*�r'� -� _ _�-'ti' �-` ti- �.,. ■� 4 �rG�.
a #■•�l yy i■ i�•e G "� 1 a f-r
L � 14 • ■w ' �� X.P
•+'rcc
l r : _ ■' ` +F ' r .; a+ _ - -;' {{+'} . .� y } - _ ` 1 _ .'*'r f;JG`. ' .. -
CONSTRUCTION INFORMATION. �:' '� ■ i 1•�, may• .•�r�: �:�-�'''F P�' y r-' 'Y4 R �?'s.-
iJ :+-. �: r '+lf of Yl {.- -- -�+�_s �dL. a'f}.��_ t�i-J-l.i�Y VL. .i
Additional work to
be performed under
this permit — check
all that apply:
_Mechanical
_Gas Tank
_Gas Piping
_Shutters
Electric
_Plumbing
Total Sq. Ft of Construction
Cost of Construction,: $
_ Sprinklers
Generator
mnwpbm�
)C1Nindaws/Doors Pond
Sq. Ft. of First Floor:
Utilities: ^ Sewer _ S e p tic Building Heights. ft�
Roof Pitch
AMEEEWM�
i - F i 1 'F I
� �' li i'•�``' �'+. racy � FEi - � r� y�+r - _ ��� }r' {r•
. , Y f �.OWNER/L ESSEE.d +� a � ��'�� � _ + _ y � .-i r _
_} `�J. ter+,• 'r r: i :'
J , `.�,-jf� �f' 1•+I �,.� .4r,' � yr r .� i• ,+
r �1'�` r_F--
CONTRA OR
--i f � /.. ; _r °� - '. }' J: _ } f F ,, -'yF � �' .� J• a. v r , �
_-`-'+dl�'� ■ �r . ����,1r� �,.1���' f''.�,� � E'��F+�+?��i+M�l r� �T'����+�_i rt
k
k T• d �_'i-_� � _ _ .- - G � - _ a_•
momdbmi
NameLQ M
Impw
l cq_M
I
Addresse 3
Com a PA ur\thi
'I -
r-
City: C D State.(X
LCI U1 A
A L) (z
ZipCode:C Fax.
city:.Mlm!
State*.
Phone No.
Zip Code
Fax,*. N I A
E-wMaill.s.
Phone
Fill min feesiample ritle Holder n new If d'ifferent
E-Mail....,
&TS (vAA&( L C fA
owner PostedStatefrom the above)
r County License
r 00
ff value of construction b 25W or more, a RECORDED Notice of Commencement Is required.
If value of HAVC is $7,5W or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
OL
qP
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name•
Address: Address:
City: State: City: State:
Zips* PRO Zip'
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name: 4 OL
Address: Address:
City: City:
ZiIt
p: P h o e: Zips Phone:
OWNER/ CONTRACTOR AFFIDVITG, 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
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 resultin 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 o=btai financing, consult
with lende%or an attorney before commencing work or recordingvo�.iG.Al of Cgcement.
Signature of Clkner/ Lessie/Contractor as Agent for owner
STATE OF
COUNTY OFFLORIDA
Swann to (or affirmed and subscribed before me of
�C Physical Presence or Online Notarization
this ?.Wv. day of 2021 by 7,( "Z(
Name of person making statement.
Personally Known
Type of Identification �L
Produced
(Signature of Notary Publi
Commission No.
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
ev, �5/6/zu
OR Produced Identification
FRONT
COUNTER
a
If rr.. rotary �'�a� 5fi-
�te aT F100P
tot
gf FI
cr a
���mmission Gb 297
EXPOS 021031202V L
ZONING
REVIEW
SUPERVISOR
REVIEW
Signature:
oi�eFirad�/License Holder
4STATE OF FLORIDA
COUNTY OF BF�0�1�1P�P�
Sworn to (or affirmedy and subscribed before me of
�A Phvsical Presence or online Notarization
this � day of M AECT 202( by �
Name of person making statement.
,"64a11y Known
12e of W
oduced
OR Produced Identification
ignature of Notary Public
mmission No.
PLANS
REVIEW
VE-GETAIION
REVIEW
I-L Notary Pubi+c State of Fond
Viviano Zuleta
,A � YOF
My Cammiss,on GG 297B40
~?..__.EXDires 0210312423
(Seal)
SEA TURTLE
REVIEW
MANGROVE
REVIEW