HomeMy WebLinkAboutBuilding Permit ApplicationAll, APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: —/ • % � • --' 1 Permit Number: a1 0 T 0 1 q
940 WC��� _ RECEIVED
Building Permit Application
Permitting Department
Planning and Development Services St. Lucie County
Building and Code Regulation Division Commercial X Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 � !�9
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PERMIT APPLICATION FOR:
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�I P1QPOSED'NIPRQUEME(V fuLOCATION
Address: fOlb joutn reaerai tiwy, tort St. Lucie, t-L cjMV00 Lc e OC&OL
Property Tax ID #: 3422-858-0001-000-7 Lot No.
Site Plan Name: 6" Wsh
Project Name: Prima Vista Crossing
ADA asphalt work to install ramp and curb
New Electrical Meter IV,+ Second Electrical Meter.
9
Block No.
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:
Cost of Construction: $
Name PR Prima Vista Crossing, LLC.
Address: 1541 Sunset Drive, Suite #300
City: Coral Gables State:
Zip Code: 33143 Fax: 305-667-1586
Phone No. 305-666-2140
E-Mail: JSCOTT@SECENTERS.COM
Sq. Ft. of First Floor:
Utilities: Sewer t L Septic
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Building Height: NA
Name: ✓
Company: G'�/9�_ &A0
Address:, Ao'Y _6Iy eo&l DZ 7
City: ��� C.- State:.
Zip Code: Fax:
Phone No i7Z 3RO - bSg1
E-Mail C6AUS I0
State or County Licensed`.,a 05-930—
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
Name:
Addre:
City: _
Zip:
Phone
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:_
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
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 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-Qr an -attorney before commencing work or recordinaNetti�Natic_e of Commencement.
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O er/ Lessee/Contract a gent for Ow er
Signature of Contractor/Licen Holder
C
rTATE
OF FLORIDA
STATE OF FLORIPA
COUNTY OF MIAMI DADE
COUNTY OF
CC
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
M
72
Ph�y�s�ical Presence or Online Notarization
this 7�`+"day Of JANUARY 202# by
Physical Presence or Online Notarization
this Wday of � c.( 202$ by
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JEFF SCOTT, OWNER AGENT
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Name of person making statement.
Name of person making statement.
Personally Known)( Produced Identification
Personally Known OR Produced IdentificationcS.
Type of Identification
Produced
Type of Identification
Produced �2 7L- /�%�—
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(Si at r of Notary Pubic; `e ; ,H�IER
( ignature of Nota Pubis blic State of F]2024
` Commission # HH 450S1Ipfl{bI
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?OF . M C ves 5e 21Commission No. Y QJe;'agxP' PCommission
No.ed
through National Notaryiti.:..,@AGGi„r,
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Rev. 5/b/ZU