HomeMy WebLinkAboutcaglioni building permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
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
PERMIT APPLICATION FOR:
Permit Number:
Building Permit Application
Residential X
Address: btoQd Ivt I I1VU00d UrIve.'I 1-Dr-f r ierce-, t-L- jLfHH�)
Property Tax ID #: 01311 - to Q ! - oo ( i " 000 1(0 Lot No. y _5
iitp Plan Nnmp- Block No.
New 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
XElectric T Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height:
C?�IVNR/LESSEE __ Cfi3NRACTUR
Address: I'V,20Y IV►
City: h 'I? -t I e- ('tie- State: FL
54 Zip Code: q L4 Fax:
Phone No. ( f�grQ4 _ f D13 0(_ 6
E-Mail: i
Fill in fee simple Title Ho der on next page (if different
from the Owner listed above)
Company: i�Xl l�Y
Address: 3+'SW e S : &L iC V ja_
City: I!+1 S4- . jii.LCiC —Stater
Zip Code: 34CIS-3 Fax:
Phone No T-TZ ` o 7�-33
E-Mail toy-irklmeo 0L)6ft ( •
State or County License 49
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.
$UpPLENt�NTAL CdNSTRUCTItJN Lf�N LA�I INEQRI�iAT)ON `- -
DESIGNER%ENGINEER: i Not Applicable MORTGAGE COMPANY: Not Applicable
Name: I ( Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address.
City:
Zip: Phone:
Address:
City: State:
Zip: Phone:
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 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
..,7+M landar e%r mn nt+nrnev hafnra rnmmanrino wnrk nr rarnrelinu vnur NntirE of Commencement.
Signature of Owner/ Lessee/Contra r as Agent for Owner
SS gnature of Contractor/license Holder
STATE OF FLORIDA_�
STATE OF FLORIDA Pal �6k
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COUNTY OF �t •�
COUNTY OF m
S o to (or affirmed) and subscribed before me of
S n to {or affirmed} and subscribed before me of
Physical Presence or Online Notarization
this day Of 20Arby
hysical Pres ce or Online No�rizaiion
this day of 2020 by
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Name of person making statement.
Name of person making statement.
Y
Personally Known OR Produced Identi ation
Personally Known OR Produced Identification
Type of Iden ' ca ion
Type of identification
Produced
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Produced
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(Sign ure of Notary Publi - a e of FloMap{Signature
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of Notary Public- State Florida }
Commission No. D�SWA do
Commission No. F"V%OV��
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DATE
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DATE
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Rev. 5/6115