HomeMy WebLinkAboutgibney permit appAIIAPPLICABL,EINF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: d02 11
al Permit Number:
G Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION;
Address: �7� �L ((SO�QZ QVe
PropertyTaxlD#:�- 19I S-00
Site Plan Name: rl Ct CetiClt
Project Name: ('+; b0eA
DETAILED DESCRIPTION OF WORK:
%n4-iII nwI al-O0
New Electrical Meter Second Electrical M
CONSTRUCTION INFORMATION:
Residential ✓
�b 01 L� E r4.10si re lv� I 2 V0 Df
Est mac. 3c,9g3
- 000 -9 Lot No. I
Block No.
IG1OSLIC LL) 4;J OCj*�-
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: Sq. Ft. of First Floor:
Utilities: Sewer Septic
Cost of Construction: $ I � �� � � - _
Building Height:
OWNER/LESSEE:
CONT
OR:
Name +
Name:
PPN I
Address:171 AV&
Company:
t4 it fl
City: L State:oa
Zip Code: g Fax: I ZZ�00,�
Phone No. — ?2i5000
E-Mail: c t J49A4 0AN?/ W X rt(.,
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Address
166t►g �r(��¢��l
City: �..OY�'-h op State:
Zip Code: 38y7U Fax: S61 wzM2 005y
Phone PN 1561 q 27 $000
E-Mail i 1QQ11 AeLL 60 1 a
Q • (W
State or County License ] M Y
tt vawe
of
construction is
ZSUU 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: _ Not Appl
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _Nat Applicable
Name:
City:
Zip:.
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Phone:
BONDING COMPANY: _Not Applicable
Name:_
Address:
City:_
uwrvttt/ LUry I KAG I UK AhhIUVf I: 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 Commencemen a esult in paying twice for
improvements to yo roperty. A Notice of Commencement mus be re orded in the public records of St.
Lucie County and sted on the jobsite before the first i ection. you i teytd to obtain financing, consult
wi�b 4aryder or al attor y bpfope commencing wor reco ding v r N tl',cre �f Commencement.
as Agent for Owner
STATE OF FLORIDA /k+C
COUNTY OF Y�
Sworn to (or affirmed) and subscribed before me of
Physical Pr cote or Online Notarization
this day f 2026 by a
ti O m
Personally Known ✓ OR Produced Ic rpfar
Type of Identification O H �—
Produced Xr 2 w O w
(Signature of Notary Public- State of Florid 1 0'
610a0
STATE OF FLOR A
COUNTY OF � C
Sworn to (or affirmed) and subscribed before me of
Phyysical Presence or ✓Online Notarization
this?Zday"M�
/t2 202' by
�I
Name of erson making statement. o
O N
Personally Known OR Produced Id mfIG9 m
Type of Identification u <N
Produced } LLo c09 N
(Signature of Notary Public- State of
Commission No. (Seal) � Commission No,
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