HomeMy WebLinkAboutslade permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
LLLL
1� 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) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: (`'�(c .
PROPOSED IMPROVEMENTLOCATION:
Address: 4S
j ) N � cy
PropertyTax lD #: '�j`�—�t��� —`((may — Lot No. I
Site Plan Name: _ 01i 1, �i�i�("�I Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
NJ
1
a vV �
New Electrical Meter Second Electrical Meter (Affidavit required)
FONSTRUCTION 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 - Pitch
Total Sq. Ft of Construction: J J0 2 - Sq. Ft. of First Floor: ��5 ,` G
Cost of Construction: $ l 80 (DO Utilities: _ Sewer _ Septic Building Height: _
OWNER/LESSEE:
CONTRACTOR:
NameUta�k\1 I�`�C �f' 1
Name: ! j.
Address: i150 I ids �
Company: C)
City: _� , li State: L
Address: e-' (J j rJ.
Zip Code: Fax:
__1_J
City: �fP I C VCC tate: .
Phone No. Z. 22- , ��k�l � t E-
Zip Code: 3 r. ±5 Fax:
Mail: G:4 �`I1
Phone No
Fill in fee si ple Title Holder on net page if different
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E-Mail 'i i'�' � (`, ,
L� 4 ail �G COT)
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from the Owner listed above
State or County License C. I 3S i�A_ Z _ 31 Q 5 j
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: Not Applicable
Name:
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
Address:
City: State:
Zip: Phone
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:, Not Applicable
Name:
Address:
BONDING COMPANY:
Name:
Not Applicable
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNFR/ rn1UTRerTnD n[cJnvrr.
-- - - - • •- -- • --.- .... nNNnUauuI i 1�, nereoy mace to ontain 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 conflicts with any. applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consu t with your Homeowners 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 hpfnrp rnmmonrinn,.,,,rl. „�, �;� __ hJ_ !__ _r
- - - -- �I �v�v, uII IV, VIJUr ivuuce of Commencement.
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Signature of Own er/Zessee/Contractor as Agent for Owner
STATE OF FLORIDA <s ��� .
COUNTY OF
Swor : o (or affirmed) a subscribed before me of Physical Presence or Online Notarization
this day o]f 20 by
L..L'115a�i S
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification Pr duced
(Sig tur f t - tate of Florida)
Commission No. ( Seat )rRyE KAiHERINEHAVEN5
+s •..
" MY COMMISSION#GG165030
EXPIRES: DEC 04,
2021
" Bonded through 1st State Insurance
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
VEGETATION
SEA TURTLE
MANGROVE
DATE
REVIEW
REVIEW
REVIEW
REVIEW
RECEIVED
DATE
COMPLETED
ev 5120121