HomeMy WebLinkAboutBuilding Permit Application - Robert HaukapAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Jt JL1 `t . 2-0 {
Permit Number:
LL u'c�1
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial Residential Y,
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: .°awl b 7 ..Z Al i,4Al
Property Tax ID #: L2 i &61::: C f C, 0 -
Lot No. f
Site Plan Name: / i Ci Krt P--�—
Block No.
Project Name: iIVS :7f-L.L PVL_ ✓�Lafi: �1 / -
DETAILED DESCRIPTION OF WORK:
Lie?ce #-fcit- tgi,
:i
iAlij- LL 2.34'L_-F. Ut`;T
o
N L 7 i L
- t _
Ow_Li� - !
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
` Electric — Plumbing — Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ r ! , 4/,Q0 ,
OWNERAESSEE:
(Affidavit required)
Shutters Windows/Doors Pond
— Generator Roof pitch
Sq. Ft. of First Floor;
Utilities: _ Sewer — Septic Building Height:
Name !' CC'C 'r`'r' /f�9Ut�Sf fl""
Address: SICK rlcE�Srr� Qb b,;E
City... I1 fits. State: l^,L
Zip Code: .i,q t i—1 Fax:
Phone No. q2s"fi8`tSF
E-Mail: O f3%f '7cV,,7(�
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: C1.'t-A ALI *-L
Company: 0A
Address: '7.1-/ ,cti.,i 4i-1,j t,1fL
City: Cea:�ii C vci State: FL
Zip Code: ,1 15 '�8� Fax: )72 'IoPi U
Phone No 7 7L 8i 2_ -1
E-Mail iojrzL j!�,4 Gi cN i
State or County License G LAC- J'-x.;; y S`7
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
Address:
City:
zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
Not Applicable
State
— Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
zip:. Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: phone:
Not Applicable
tate:
—Not Applicable
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 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 an restrictions which may apply.
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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 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 osted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or a att_ ne before cOMMencinn, work or recordi tour Notice of Commencement.
I` 1-17
Signature of Owne essee/Contractor a
nt for Owner
STATE OF FLORIDA
COUNTY OF Y 1 Lyc c ,� �•�
Sworn to (or affirmed) and subscribed before me of
this � day of ,J L'._,i X Physical Presence or Online Notarization
20 �,! by
Name of person making statement.
Personally Known ✓ OR Produced Identification
Type of identification Produced
(Signature of Notary
Commission No. (Seal)
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev 5
CRYSTAL Y BISJ-i'CP
My COMMISSION # GG127618
EXPIRI=S July 21
24, 20
SUPERVISOR I PLAIN
REVIEW REVIE
JS
W
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW