HomeMy WebLinkAboutBuilding Permit package All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 65191192, Permit Number:
RECEIVED
® JUN 01 1011
Building Permit Application Matftq Department
Planning and Development Services ' County
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: �� 4
>P,ROPOSEO IMPROVEMENT LOCATION:.
Address: 140 'Princess Tr, Sk LtAcic �l• �y9��
Property Tax ID#: 31-//9 - 5,9 0 - (3o 3 Z - no 0- Lot No.
Site Plan Name: Block No. /6
Project Name:—� �(er['P��.► �1 e a v rc c .
b,ETAI 'ED DESC,RIPTION'.OF 1NORK "
FO/r ' X OctJi
U ,�
o �v4ikne_ (2�,xlY o eknLg
New Electrical Meter Second Electrical Meter
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coNs-i=> ucTloN InIFORMaTIoN ` ,�f �� z
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: 1h& Ste, h. Sq. Ft. of First Floor:
Cost of Construction:$,7-0 Utilities: _Seiver _Septic Building Height:
01UNER/LESSEE CONTRACTOR
Name D { Name: 'IZc�f.A -Sn C;.,A,7
Address: n
9055'r '►Dud Company: (mean Q',Vo
�vici
State: F1. Address: $/ 6 A�r)r,,,,h
Zip Code: .34f S3 Fax: City:'% , Zee CC e State: EL.
Phone No. Zip Code: 3 lelg7 Fax:
E-Mail: Phone No (7190 26 L L?L//
Fill in fee simple Title Holder on next page(if different E-Mail CT,,, C,y, (9,,,4 cr&fir. i n /1r .nVL/X' M
from the Owner listed above) State or County License RC 1, 2 3 ,2 G LN
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: K,Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: Not Applicable BONDING COMPANY: XNot 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 po ted on the jobsite before the first inspection. If you intend to obtain financing, consult
wi a der r an rneV befgm_commencing work or recording ur NotiM of Commencement.
T
Signatu of O r Le a Co as Agent for Owner ur f Co tractor/Lice
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Ltil r_\'Z COUNTY OF 5 ,1r�Se6�
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 SJ Iyk 202C1 by this!_N_day of J Uy\c 202q by
Name of person making Aatement. Name of person making statement:
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced L QL-- Produced
(Signature of Nota ublic-State of Florida) ignature of NoZa
F orida
DEANNAGIVENS DNq�iIV'cN5Commission No. pd�o35 o Seal ry t ate of Florida
�:. No ary Public State of nor' CC mmission NO. = Nota P aCommission;HH 086359 = Commission X HH 086359 My Comm.Expires Jan 28 20m.Expires Jan 28,2 25
Bonded t rough Nations o n e throughNational Notary Assn,
REVIEWS FRONT OR PLANS VEGETATION SEAT R E
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
iev.5/6/20
RECEIVED
JUN m 1' 2021
Permitting Department
St. Lucie County
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