HomeMy WebLinkAboutBuilding Permit Application - 139 Pepper All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date : Permit Number :
r .
`� ° DD , Lk\ 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 : E R I C A L
'PROPOSED IMPROVEMENT LOCATION .' -
Address : I � I � EPQER `..tJ �E NS �l�I �UE FICH FL 3L4q5 `7
Property Tax lD # : I � � O�j - �OI �j - C� C'�C� ` q �L3t�`f I2tC LotNo .4SI -9 _
Site Plan Name : Block No .
Project Name :
DETAILED DESCRIPTION OF WORK :'
row- LRCE r=x �I. NDDOR I f5o 6M P.-..j I A ) N (3 R EH 1t E(Z PA K 5 L 6
TO Tw o New t '-i O AMP :J7,NDOOR MOIN 13R6081ewA5R PANELS .
Ill OrtE : C H A NGING ou -r 6ECRU ,5e, nr- C14 A LL r- NG!:MR NE�.S ,
New Electrical Meter 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 -9 Sq . Ft. of First Floor :
Cost of Construction : $ Utilities : _ Sewer _ Septic Building Height :
OWNER/LESSEE CONTRACTOR :
Name O) R IAN lk ANDIR K 1--:-0 IT H N a m e :
Address :- 13 � G-P Company: .0i4AR Log
City : E1\1 E fl;c N State : rL Address . 4S2 H eRN A N Do ST. , API A
Zip Code : 3 �`�' q q Fax : City : Fo RT p l LR CG State :
5 FL
Phone No . ZlpCode : 3 . 9 L+ 9 Fax :
E - Mail : PhoneN r170?) 332 --. 91, 08
Fill in fee simple Title Holder on next page if different E- Mail C L c) u.� 2 Pk ec,- ri' a @ no ( • ea rn
from the Owner listed above) State or County License �20 9 Iq I
Lo:m-o R *t-oD1511I
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 .
SUPPL�EM:E:NTAL 'CONSTRU.CT'l.-O-N LI E N LAW I N FORMATION
DESiGNER/.-ENGINEER : Not Applicable MORTGAGE COMPANY: Not Applicable
Name : Name :
Address : Address :
City : State : City : State :
Zip : Phone Zip : Phone :
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name : Name :
Address : Address:
City: city:
Zip : Phoned. di p : Phone :
OWNER/ CONTRACTOR AFFIDVIT: Applicationis hereby made to obtain a permit to do the work and installation as indicated.
certify that no wont 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 1 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 strictures, 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, consul
with lender or an attorney before commencing work or recording your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for owner Signature of Contractor/License Holder
STATE OF FLORIDA �S+
STATE aF FLORiDA
COUNTY OF COUNTY OF
Sw n to (or affirmed ) and subscribed before me of Sworn to (or affirmed ) and subscribed before me of
ysical Pres ce or Online Notarization V_ ysical Presence or Online Notarization
this day of 2020 by this day of V7V r,) 2020 by
Name of person making statement. Name of person making statement.
Personally Known \,O OR Produced identification Personally Known �_ OR Produced Identification
Type of Identification Type of Identification
Produced Produced
F
.% 1110111111ou
Notetry Public Scats t# kxida � Notary �'u#�ic Stabr d%.,�_ Fbricla
Sabrina wl Arrington
_ -k.- -
(Signature f 'Notary Pu i � � o ?��x3 (Signature o Notary P ' c�i�F�� GG Ooez70
ja Expires ON27/2023
Commission No , (Seal ) Commission No. 0� 0�
J 'J
REVI EWS FRONT ZONING SU PERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVI EW REVI EW REVIEW REVI EW
DATA
RECEIVED
DATE �
COMPLETED I.
Rev . 5/ 6