HomeMy WebLinkAbout1 Permit app WyszAll APPLICABLE INFO MUST BE COMPLETED rOR APPLICATION TO BE ACCEPTED
1
Date. , i Permit Nzirnher:
Building Permit Application
P1017nirrg and Developmen t Services
Building and Code Regufation0ivisron omJ` ercfdf _ Resi{ entiaf
2300 Virginia Avenue, Fort Pierce Ft 34992
Prone: {772) 462-1553 Fax: (772) 452--1578
IVIITAPPLICATION FOR: ���fCLrn 14 ..CS k
PROPOSED MPROVEMEINT LOCATION
Address; `� x
Property Tax JD o coo S - 01 Lot No. J `
Site Plan N'�Me: - � Block No-
_ —
Prvject Name: ,f--
DETAILED DESCRIPTION OF WORK:
New Electrical Meter ! Second Electrical Meter
CON,STRUCTI0I JNFORMATION:
Additional work to be performed under this perrnit -check all that apply:
' �+Ilechanical _ Gas Tank _ Gas Piping _ Shutters Windows/Doors _ Pond
Electric + lumbing _ Sprinklers _ Generator Roof LPf 1 Pitch
Total Sq_ Ft of ConStrtuction: 0+ 1 I Sq. Ft_ of First Floor: r
COSt of Constructlaw "t r ri
Utilities= Sewer �eptic Building Height-
OWNER/LESSEE:
Address: 77 SW ROY 1ny r000-
state.
Zip Cod:J Fax=
Phone w. -1`70 -a1 - p
E-Mail: -
Fill in fee simple Title Folder on next page ( if different
f re m the Own e r listed above)
CONTRACTOR.
Name: Andrew Nadalin
Company: Pace 2000, Inc-
Addre5s:445 NW Prima Vista Blvd.
City; Port St Lucie
State: FL
Fax: _
Prone No 77 -940-7 3
E -ma il admin 0P pace 000home .com
State or County License C BC 0598 9
Zip Code: 3498
Jf va I u e of construction is 25UO or more, a RECORDED Notice of Corr mencemerrt is required.
If value of HAVC Fs 7,S00 or more, a RECORDED Notice of Cornmancement is required.
KSUPPLEMENTAL CONSTRUCTION UEN LAW INFOR #ATION.
DESI N14R/ENGINEER: Not Appl[cable MORTGAGE COMPANY
N
z Not Applicable
a rrle, N a me :
Address- fcl I C i. Address.
City, Stater City:
Zip: Phone - W7. Zip: State:,
Phone:_
FEE SIMPLE TITLE HOLDER: Nat Applicable
Name.
Address:
City:
Zip: Phone:
BONDING COMPANY -
Address;
City:_
Zip- � Phone,
Applicabile
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 corn menoed prior to the issuance of a permit.
SL Lucie Coun ty 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 Assouation rules, bylaws or and covenants that relay restOct or prohibit such
structure. Phase consult with your Home Owners Assch
ociation and review your deed for any restrictions whimay 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 flans, the Florida Building Codes and St, Lucie County Amendments,
The following building perm it applications are exempt from undergoing a full ccncurrency review. room additions,
ar-cessory structures, swimming pools, fences, wa[is, signs, scrf2en rooms and acoessory uses to another non-residential use
WARN INCa TO OWNER. Your failure to record a Notice of Commencement may result in paying twice for
imprevernents to your property. A Notice of Commencement must be recorded irr the public records of St.
Lucie County and posted on the jobsite before the first i nspection. If you intend to obtain« financi ng, Consalt
with lender or a n a tterney before comrnenci ng work or recording our Notice of Commencement.
Signature of 1 ++^e; + nt frrr p,vner SignaturI of , a
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF _ COUNTY OF i
Zrn t (or atJFrmed) and subscribed before me of
Ph slcal Presen a or Online Notarization
day of 2020 by
Narne of person making statement_
Personally Known OR Produced Identification.
Type of Identification
Pr ced
(Signature of Notary P I' Flori
Commission No, EXON)SePL 1, 2W
REVIEWS I FRONT ZONING
f COUNTER I REVIEW
DATE
RECEIVED
DATE
COMPLETED
Swan to (or affirmed) and subscribed before me of
_ J} ysicaI Presen a or Online Notarization
this day of 202V by
-Aryl-rew, r l .Cb n
Name of person making statement
Personally Known -. Y OR Produced Identification _
Type of Identification
Produced
(Signature of Notary PueFit i .#F�I� 37951
'Brew
or mission No,
� .15, 2024
.4
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