HomeMy WebLinkAboutAPPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: -`— -----____,_
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Con.11mercial Residential x
2300 Virginia Avenue, J=ort Pierce FL.34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR: Building
L �� RN'.. ��>�L4� � �x�' ��;sr^•�:y N 'y .k, . � r V� r. S i� �`ry-r�....
Address: 4931 Southwind Trail Fort Pierce, Fl 34951
Property Tax ID#: 1418-241-0035-000-1 Lot No.
Site Plan Name: Sill and Lauren Skopelja Block No.
Project Name: Sill and Lauren Skopelj_aAA
y
Construction of new Steel Building
Ne'vF.Electrical Meter Second Electrical Meter ,
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: 2400 Sq. Ft. of First Floor: 2400
Cost of Construction: $ 70,000 Utilities: _Sewer Septic Building Height: 14'___„___
p,
Name William k Shopcija_ Nan�e:Gorc�)n fV, vVorley
Address:6605 Green Dolphin St I Company:G.M. Worley, Inc.
City: Fort Pierce - � �State,__ Address:110 Nw 5th Street
Zip Code: 34951 Fax:__ City: Okeechobee State:FI
I Phone No.291-808-7701 — Lip Code: 34972 Fax: 863-467-2238
E-Mail: will iem(cinjuredinflorida.com; Y � Phone No 863-467-2541 _
Fill in fee simple Title Haider on next page(if different E-Mail gmworley@gmail.com
from the Owner listed above) State or County License6GC1507657
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.�� T
If value of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required.
t. OWN.
DESIGNER/ENGINEER: ,Not Applicable MORTGAGE COMPANY: ^Not Applicable
Name: Moore and Associates Engineering and Consul6ng,Inc. Name:
Address: 1009 E A,. Address:
City: NorlhAugusta State: sc City: State:_
Zip: 27017 Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: ___..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;obsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or recording your((N�Ioti a of Commencement.
Signature of Owner/Lessee/Contractor as Agent for owner Signature of Contractor/License Holder
STATE OF FLORI A STATE OF FLORIDA
COUNTY OF�(� COUNTY OF,��I'� �.Q.��
5w n to(or affirmed)and subscribed before me of S n to(or affirmed)and subscribed before me of
hysical Pres nc or Online Notarization _ Physical Presence or_ Online Notarization
this day of _,2p2$ by this day of 20?1[ by
�a
Name of person making statement, Name of person making sta ent.
Personally Known OR Produced Identification Personally Known_ OR Produced Identification
Type of Identification Type of Identification
Produced Produced
)"L)- AA
(Signat of Notary Public-State ' of Notary Pub Ic-State fElodrIaLL
Ay- MYRANOA IRLS i�^ I MYRANDAWHI L
Commission No. ( ; a MY COMMISSION 9�1110887t4dssi No. _,: t. MYCOMMISSIONa� 6744
,- EXPIRES:Nov 24,2024 P`•a EXPIRES:November 024
FaF.moo .
n nwr tern
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANUKUVL
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE —
RECEIVED
DATE
COMPLETED
ev.