HomeMy WebLinkAbout7004 Citrus Park Bv Permit App 23JUN2021All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
LLLJ!-r �-
L, ff Bu*i1d*ing
Perm'it Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Ford Pierce FL 34982
Phone. (772) 462-15S3 Fax: (772) 462-IS78
PERMIT APPLICATION FOR:
F-1% %A " I %_ U-P %J s it s w * -a -w-W Tauff w w --
Property Tax ID #:
Commercial
(0c) 38
Residential
t T
Site Plan Name.- �—W � I k' an
Project Name:
DETAILED DESCRIPTION OF WORK0
:
GE 6
Wl
Lot No. S
Block No. 109bluo
R PAts*,IEL Fo
INSURANCC PuRP05 1� S. Tio At4 ACCoS FTED B
RAND 1150 AMP M./L3
66K PANS L's .
(PANEL ONU
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
)( Electric
_ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ _ 1 #1 5"()() &�.
_Sprinklers
Generator
Sq. Ft. of First Floor. -
Windows/Doors Pond
Roof Pitch
Utilities: _Sewer _ Septic Building Height:
OWNER/LESSEE.: CONTRACTOR:
Name ,AUNName:(21-1R2LL5 �.-OWL
Address: 7001'i ITRU5 P/4RJ< 13%-VI) cornpany:CjiAi'ZLes LowE ��CGT"R.IC.� SNC•
City: Ivr P/,5JK6 C.-W State: FL Address:-- ;z H 6 &N 4N DO 3-r.� A Pr-
Zip Code: "3 14 9 S I Fax: City: Flo RI.T P I C--OO RCS State:. Ee-w L
Phone No. Zip Code: ?J Li q Lq 9 Fax:
E-Mail: Phone No 2 - 9tto
Fill in fee simple Title Holder on next page ( if different E-M a i I l�{..O(J�e FI CC+rl C I RC.@ ONA06� • tb1Yi
from the Owner listed above) State or County License 9 6 9141 1E,-8 o015111
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.
N LIEN LAW INFORMATION:
SUPFLEMENTALCONSTRUCTIO
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: Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: 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 rues, 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 posted on the jobsite before the first inspection. If you intend to obtain financing, consul
with lender or an attorney before commencing work or recordin oy.r_Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORID
COUNTY OF �C
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this' day of Anj 2021 by
Signature of Contra ctor/Lice n se Holder
STATE OF FLORIDA
COUNTY OF �
this
n to (or affirmed) and subscribed before me of
Physical Pres rice or online N tarization
Z day of , 2021 by
(?� �f 1i - V ( � ) ()� �( "� e
1eo�,s L n�' N
Name of person malting statement.
Personally Known T�
Type of Identification
Produced
(Signature
Commission No.
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
ear,
OR Produced Identification
Lary Public-- State of Florida )
Name of person making statement.
Personably Known.
Type of Identification
Produced
DR Produced Identification
(Signature of Notary Puii6dState of Florida }
AlzAL Aft
ti ,�� a�$�,dp� ommission No.Oa)l
Sabrina M Affington
comm"es= GG 9062t9
• aw Exgres 7f2023 j Va ow
FRONT PLANS VEGETATION
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW
NbUljl Public Stale of Florid
Sabrina M Arrington
M� Commission GG M274
Expi *s 08127I2023
REVIEW