HomeMy WebLinkAboutpermit 8613 tomoson point rdAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
L UICULF
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1S78
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: j
— f r �
Property Tax l D #: (� q i5 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
TI , Gln a Uniz� ✓`puma 1`�
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 _A Roof /.7 Pitch
Total Sq. Ft of Construction: ��i.i9 Sq. Ft. of First Floor:
Cost of Construction: $ qc4 X0 Utilities: —Sewer _Septic Building Height: 51f.
OWNER/LESSEE:
NTRACTOR:
Name ✓ ! :
rme
Address: it mpany:City:
C'4 l/ C State: A dress: I $ l6 SW lot /ltpit f�.
Zip Code: 3y? 9 ( Fax: City: Red r'l, State
Phone No. Scz, 7 /' O/J Zip Code: 3 9 8 e/ Fax:
E-Mail: Phone No 7a - 310 - 1110
Fill in fee simple Title Holder on next page (if different E-Mail C Oct r'? LC C' 1, 4
r117010e
from the Owner listed above) State or County License
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.
DESIGNER/ENGINEER:
_ Not Applicable I MORTGAGE COMPANY:
_ Not Applicable
Name:
Name:
Address:
Address:
City:
State: City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER:
_ 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 instal Iation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Count 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 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, consult
with lender or an attorney before commencing work or recording your Notice of Commencement.
Signature of Owner/ Con nor as Agen or qwn . Signature ofCon r42orxc>1111
I d e r
STATE OF FLORIDA STATE OF FLORIDA S) /V
COUNTY OF , S GVa _ COUNTY OF tt CiC" Ew
Sworn to (or affirmed) and subscribed before n
,yg Physical Present or Online Notari
this day of WAY , 2020 by
of person making statement.
Personally Known ��. OR Produced I
Type of Identification
Commission No. (Seal)
REVIEWS FRONT ZONING
COUNTER REVIEW
COMPLETED
Sworn to (or affirmed) and subscribed before me of
Q< Physical Presence or Online Notarization
$ this -,20day of '10iA7 .2020 by
as rirn RletuvL
Name of person making statement.
Personally Known A� OR Produced
Type of Identification
(Signature of Notary Mblic- State of
Commission Nc. a_&_-(9A/d-9d- (Seal)
jSUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW