HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLI
Dat PermDNum :
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LJUL 2 S 2021
- �- fldinggPer RRF11160LIon 5t.Lucie County
Planning and Development Services Permitting
Building and Code Regulation Division Commercial YES Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR:
.PROPOSED IMPROVEMENT LOCATION:
Address: 4343 US Hwy 1 Ft. Pierce, FL 34946
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PropertyTax ID#: 14-20-141-0003-0008 Lot No.
Site Plan Name: Block No.
Project Name: She
DETAILED DESCRIPTION OFWORK:
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New Electrical Meter Second Electrical Meter N(ft
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 _Roof Pitch
Total Sq. Ft of Construction: 1O)SIq !y,9 Sq. Ft. of First Floor:
Cost of Construction: $ JrO Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
NameSusan and Baruch Carmelli Name:Michael Slayton
Address:2507 N.Ocean Drive Company:Slayton Construction Corp
City: Ft Pierce State:_ Address:605 SW Park St
Zip Code: 34949 Fax: .City: Okeechobee State:FL
Phone No.516-641-7795 Zip Code: 34973 Fax:
E-Mail:ourcastiedream@gmail.com Phone No540-447-4297(Rodney)
Fitt in fee simple Title Holder on next page(if different E-MailRSoulsbyii@gmail.com
from the Owner listed above) State or County License State Cert.Building Contractor
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.
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.SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: i _Not Applicable MOR GE COMPANY: -"'Not Applicable
Name: �o.�r;�r 'kels JAC Name:
Address: 2 3Z3 S• 1f Ii z f— Avg Address:
City: ti C fi Stater City: State:
Zip: 3Z�G13 Phohe 336,7?q 911�11( Zip: Phone:
F E SIMPLE TITLE HOLDER: e� Not Applicable BONiG COMPANY: _✓Not Applicable
Na Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application i reby 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 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 our Notice of Commencement.
Signature of Owner/ s ontractor as Agent for Owner Signature of C act /Li rise Holder
STATE OF FL D STATE OF LORI*and
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COUNTY OF COUNTY 4aJu
Swgpn to(or of irmed)and s bscribed before me of Swo Kto(or affirmcribed before me of
V Physical Pres a or Online Notarization P icai Pre e r Online Notarization
thi 'itay f 2020 by this y of-C T
2 20 by
Name of per n making statement. Name of person making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identificati
Produced Produced
(Signs e o No - tj/�/ (Si ure of (�1 �
a�►r Notary Public State of Florid-,., VRr ny Notary Public State of Florida
Samuel J Vul��tt��_��{
Commission No. mmissioil ,tom,U09871 Commission N ;Q k Samuel J Vuleta(Seal)
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Expires 09/03/2023 ' a F�• Expires 09/03/20mMi13 in Commission 23 909871
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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