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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPI IrARI F INFn MIIST RF rnmpi FTFn FnR APPI ICATinKI Tn RF ACCEPTED Date: Permit Number: J10r2-0q_7--),_ - p Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential J� 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: P.ROSEQ,111iIPROUEMENT LOCATfO ROFN A 6 Address: 2ILP'I'L \.vc>A \- �• Property Tax lD #: 3%\O3 - C>Op 1 Lot No. \2 Site Plan Name: R.('',!jwi0 Block No. Project Name: �Leb'crIt' DETAILED�DESCRIPTIOWOF 1NORK n .. s ` ` t�d�e�rluu w�on�r � PI's'RY►_�a\ 4 �M�v�\4S New Electrical Meter. Second Electrical Meter CONSTRUCTION INFORMATION ttx Additional work to be performed under this permit- check all that apply: (Affidavit required) _Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors Pond Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total q. Ft of055trtug-Cpn: Q Sq. Ft. of First Floor: Cost of Construction: $ 15A , -1 ©• Utilities: —Sewer —Septic Building Height: ,OWNER/LESSEE 3 CONTRACTOR Name &kV R%5oaifa Name: Zy i J ice\\ion �1�� Address: 'Zlo�72- %.A" LC b Company:•S_ncitor Q`�V�I� a �pOifrS Address: 'd�a %%4% 'n'z SW J City: �-Oyl ZQ4_ State:. Zip Code: 3ACM Fax: Phone No. City: V -YD I2CCACY% State: VL Zip Code: 3ZA47_ Fax: Phone No L '7 13--721(0 E=Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail Cjnf%WAa & 1/V) lav% riVcr tofift ccaM State or County License CSX_1 %3313%4Y If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. I4value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. SIJPPLEMENI"A�L C®„N' STR�UCTIO,N�LI=ENIAWIINFORMATION' 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. 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 your Notice of Commencement. Signature of Owner/ Lessee/Contractor as Agent for Owner STATE OF FLORIDA LoL&I� COUNTY OF Sworn to (or affirmed) and subscribed before me of X Physical Presence or Online Notarization this'Z"- day of 20by Name of person making statement. Personally Known �� OR Produced Identification Type of Identification Produced (Signature of Notary Public- States of Florida ) Rli-70—�+ l NatwyP°:� We ofFWW& Commission No. (Seal) RlcMrd T Gordon E40%AA0%0%0%0%0% nay commb.lon ►+H 077057Exphn 01/04/2025 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 5/20/21 SUPPLEMENTAL CONSTRUCTION LIEN 1l1/ INFORMATION _ 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. 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_lpnder or an attorney before commencing work or recording our Notice of Commencement. Signature of Owner Lessee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF Sworn tT(or affirmed) and subscribed before me of Physical Presence or Online Notarization thisday of � �i , 20,,�I by Name of person making statement. Personally Known Y OR Produced Identification Type of I ification P odu ed gna re of tart' P llicc-- Sta of Florida ) Commission No. v / -7 0� 40 "w Notary hard TW Stateof Florida (Seal) � � Richard T GordonGordb My Commission HH 077057 � Expires 01/0X=5 �or REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev