HomeMy WebLinkAbout45 El Camino Real (1)OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to
I certify that no work or installation has commenced prior to the i
St. Lucie Countv makes no representation that is sranting a permit will ;
which is in conflict with anv a'pplicable Home Owiers Asiociation rules,
structure. Please consult With'your Home Owners Association and revie
ln consideration of the granting of this requested permit, I do hereby
in accordance with the approved plans, the Florida Building Codes and St
The following building permit applications are exempt from undergoing
accessory structures, swimming pools, fences, walls, signs, screen rooms
WARNING TO OWNER: Your failure to Record a Notice of Com
improvements to your property. A Notice of Commence
Lucie County and posted on the jobsite before the first i
with lender or an at before commencing work or
COMPANY' x Not Applicable
Phone:
IGNI
1e:_
reSs
ENGINEER: X Not APPI|CAbIC
City:
COMPANY: x Not ApplicableFEE SIMPLE TITLE HOLDER: x Not Applicable
Add
City
zip:Phone:
ntractor as Agent for Owner
STATE OF FLORIDA-a ,
COUNTY OF -* LUL.I
Name of person making statement.
Personally Known -Z^Produced ldentification
Type of ldentification
State of Florida )
of (o ntr'{4.orlLice n se H ol de r
?iii'*3fr ure ,t
(or affirmed) and subscribed before me of
;ical Preserrce or Online Notarization
aay or J{/1.1-- ,2ozl by
of person making state_ment.
rally Known Zo^Produced ldentification
ldentification
cou
th is
Type
Prod
Com
ZONING
REVIEW
SU PERVISOR
REVIEW
FRONT
COUNTER
VEGETATION
REVIEW
MANGROVE
REVIEW
SEA TURTLE
REVIEW
DATE
RECEIVED
n a permit to do the work and installation as indicated.
of a permit.
that I will, in all respects, perform the work
Lucie County Amendments.
full concurrency review: room additions,
nd accessory uses to another non-residential use
ncement may result in paying twice for
nt must be recorded in the public records of St,
pection. lf you intend to obtain financing, consult
r Notic,e of Commencement.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
State:
zip, -[ Phone:-
NoTARY Pu$69tt
SIATE OF FLORIDA
State of Florida )
Bonrty J. Prcke
Swoja+6(or affirmed) and subscribed before me of/ Plusical Preserlce or Online Notarization
tnitoQaay of -Jfu,L ,202i by
NOTARY pUBLISeal
STATFoF plonlon
AIIAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -7- )2-?t Permit Number:
,-:i.t.':..'r r t j:, rar,r:1.',:i.*.
Building Permit Application
Plonning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772\ 452-7553 Fax: (772\ 462-1578 Commercial Residential Y
--
PERMITTYPE:
PRO POSED IMPROVEM ENT LOCATION :
Address: qf €oePm til t) 'llgrtt
Property Tax lD #:
Site Plan Name:
Lot No
Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION :
Additional work to be performed under this permit - check all that apply:
YMechanical
Electric
_ Gas Tank
_ Plumbing
_ Gas Piping _ Shutters _ Windows/Doors
_ Sprinklers
-
Generator
-
Roof
-
Pitch
Total Sq. Ft of Construction:Sq.
Utilities:
Ft. of First Floor:
costof Construction:S 3QW -OQ Sewer _ Septic Building Height:
lf value of construction is 52500 or more, a RECORDED Notice of Comm$ncement is required.
lf value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
owNER/LESSEE:CONTRACTOR:
Ntame 4,"\ra (-o.lhc-{-k
Address: (dS
City: ?r>rt SL L.rc"ie State:-EL
Zip Code: Stt1{2 Fax:
Phone trto..{ri t}?S YL {.e
Fill in fee simple Title
from the Owner listed above)
Name:
Company:
Address: S
Phone No1'?3 323 t (G1
e-vrail ear,,,F he.tt ccr./. e a;rrt .hs- *i.=B,nd
State or County 1-;."nts C/4c */6Ac'&3r> - -
7:a
State: FL.
Zip Code: 7 ti'i K3 rax:
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