HomeMy WebLinkAboutDebbieBarrowPermitPackAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
` LUCUL
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 CBDG Funding
Residential V/
PERMIT APPLICATION FOR: F C P—
t ` H�Jc
PROPOSED IMPROVEMENT LOCATION: IGSQ
Address: 3 C0O sE CIO Grp
Property Tax ID #: A - 5 3 0 - Ok �)113 — 00 ✓ 1 Lot No.
Site Plan Name: k `yc r PGr Un (+ 4Block No.�L�
Project Name:
DETAILED DESCRIPTION OF WORK:
New Electrical Meter
Second Electrical Meter
I CONSTRUCTION INFORMATION:
(Affidavit required)
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' Sq. Ft. of First Floor
Cost of Construction: $ r1, 300 • 00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name x
Name:
Addre
Q FIKC
Compan Wa ,
City: State: L
Zip Code: �3L 'q Fax: ,, ll
Phone1�
a a `'t E-
Address:
City: V• State:
Zip Code- 34q5,3 Fax:
N
Mail:K0zP7JV_(Jb6S
(Dr4hone
Fill in fee simple Tl a Holder on next page (if different
from the Owner listed above)
E-Mail
State or County tic e
If value of construction is 2SOO or more, a RECORDED Notice of Commencement is required.
If valtia of 14Avr is C7 Snn nr mnra a RFrnRnpn Nntira of rnmmonromont ie ranirirorl
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNE
Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
State:
BONDING COMPANY: _Not Applicable
Name: _
Address:
City: _
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 conflicts with any. applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult 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 before commencing work or recording your Notice of Commencement.
611=2 'k .4 QK�ff
Signature of Owner/ Les ee/Contractor as Age for Owner
STATE OF FLORIDA
COUNTY OF J7 Lt,v;'•C
Sworn WJor affix ed) and subscribed before me of Physical Presence or Online Notarization
this day of JQ4 2o2L by
n 2
Name rA person ma n statement.
Personally Known R Produced Identification
Type Id ntif'cat' duced
G O /14F /,/
(Signature of Notary Public •b +.0•.,9
NOTAFJy N ,_
T
Commission No. ("!)• .!
..c, PUBLIC
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REVIEWS
FRONT
ZONINI(i
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 512UI21