HomeMy WebLinkAboutSLC Permit Application - Guy LicariAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: MLy 1e, Lc z t
Permit Number:
o
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1575
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: S'a;tr S'f .tieCii=L /1 VC FOsCT f�cL7c� TL .i ,yq5-1
PropertyTaxlD#: ;3Ci Lt.i' vj.�ri7
Lot No. _ _ �
Site Plan Name: i cwx, r=Lncci l jj,,-WU Block No, i ]-
ProjectName: aAi3-rev LL- ciigI4LL,Atbc eft
DETAILED DESCRIPTION OF WORK:
'Jte r' iPg-)j:l 131 AILMLat~ . Je:i x �L �'� fi •1='- tsr� j'1 %�tL C/fiii.rt L��ic a i1Ce� Lai �
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:
(Affidavit required)
_ Shutters _ Windows/Doors Pond
— Generator _ Roof pitch
Sq. Ft. of First Floor:
Cost of Construction: $ q , Lf 9L A,- c) Utilities. _ Sewer _ Septic Building Height;
OWNER/LESSEE:
Name 6Lj,1 Ltt�,nizi
Address: SIX A i,tiJ � 7 ' A VZ
City: Cvc 6Fk--C 7-Y State: FL
Zip Code: 3.32 •)-A Fax:
Phone No. -112 22 :3 &r c'
E-M a i l: Pvt :� LI,L.T7 "'1#iZ- Y-V47,Vmma7- :, t
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: A i}rz�te c 13 srti is Y
Company:
Address: 51 L`r;U•L-
City: ?e•�r- s�r Li,"L-T State: FL
Zip Code: If ;(RL Fax: 7 Z2 441a6- -o ii .Z
Phone No 7 -)1— 8 i 2 DL-) 3
E-Mail t=c Q .4
State or County License fa GC e.S">7y `71
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
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable I BONDING COMPANY:
Name:_
Address:
City:
Zip:
Not Applicable
State:
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 worst 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 worst
in accordance with the approved plans, the Florida Biding 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 an post d on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender+or`a a me b fore Commencin work or recordin our Notice of Commencement.
Signature of'Owner/ Lessee/Contract r as Agent for Owner
STATE OF FLORIDA
COUNTY OF S r Lucite
Sworn to (or affirmed) and subscribed before me of YL Physical Presence or Online Notarization
this -age day of-1)iLle 20 2-i by
Name of person making statement.
Personally Known 34— OR Produced Identification
Ty of IdentificationAroduced
-.< r
of Notary Public-
of Florida )
Commission No. (Seal)
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev
Notary Public State of Florida
Crystal E Naylon
My Commission GG 929549
264 Expires 11/0612023
S REVIEWOR REVIEW VREV EWON S R VEWLE I MRE EWVE