HomeMy WebLinkAboutAPPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 05/06/2021
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Residential X
PERMIT APPLICATION FOR:Skopelja, William & Regina
PROPOSED IMPRO`JEMENT LOCATION:
Address: TBD Southwind Trail Fort Pierce, FL 34951
Property Tax ID #: 1418-241-0040-000-9
Site Plan Name: WM & Regina Skopelja
Project Name: William and Regina Skopelja
j DETAILED DESCRIPTION OF WORK:
New construction of single family residence
New Electrical Meter X Second Electrical Meter
Lot No._
Block No.
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 ZD/« Pitch
Total Sq. Ft of Construction: I�Lo Sq. Ft. of First Floor: IC/
Cost of Construction: $ Utilities: _ Sewer , u' Septic Building Height: ?C?
OWNER/LESSEE:
CONTRACTOR:
Name William G. & Regina G. Skopelja
Name: Gordon Mack Worley
Address?J81 HarwickCirSW
Company: G.M. Worley, Inc.
City: Vero Beach State: FL
Zip Code: 32968 Fax:
Phone No. (219) 406-9337
Address:110 NW 5th Street
City: Okeechobee State: FL
Zip Code: 34972 Fax: 863-467-2238
Phone N0863-467-2541
E-Mail:` Ngskopelja44@comcast.net
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail gmworleyinc@gmail.com
State or County License CGC1 507657
IT value or construction is eyUu or more, a KLLUKUED 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/EN INEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: FILIM r, 19h ftq'f f-
_
Name:
Address: 67 1AL N Tbf au Ed
Address:
City: iJ Stater(_
City: State:
Zip: �27!54 Phone ( 99,3
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 le der or an attQoey before commencing work or recording our Notic of Commencement.
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STATE OF FLORIDA
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