HomeMy WebLinkAboutPermit Application - 425 SE Verada AveAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Co l:1.
Building Permit Application
Planning and Development Services
X
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:
PROPOSED IMPROVEMENT LOCATION:
Address: `Z 16 ViN-+Ave
Property Tax ID #: � "� " ��� -0W - Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Uivl fir c - r� 4 S a
New Electrical Meter Second Electrical Meter (Affidavit required)
[CONSTRUCTION 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: Sq. Ft. of First Floor:
Cost of Construction: $ a$ Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name tyliC.Li4,rI JoIIL6 bpi
Name: R) t 9
Address: ci Sf VirGid i Aye
'/
Company: is of Kevin MIA Z (.
cayyJ
City: PC + Ji• L"i Q State: f L
Address: 35V W r`1 I -i y t
zip Code: 3`1 l$3 Fax:
City. st.to
Phone No. E-
Zip Code: Fax: � &l"010)
Mail:
Phone No
Fill in fee simple Title Holder on next page (if different
E-Mail - Q G1.' •1
from the Owner listed above)
State or County License %cc ldpo(f y
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
Name: _
Address:
City:
Zip:
Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
Citv-
Zip: Phone: _
_ Not Applicable
State:
Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name: _
Address:
City:
Zip:
Phone:
Not Applicable
tate:
_Not Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to ao the worK ana mstallauun as IllUIl.d ICU.
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
�_ _ { •Yla liIC ,Arrlrle nr ror•nrrfinp vnur Notice of Commencement.
WIUIIeIIUeI UI C7ila Ur is ucivic...v�„�,...,„
...-..... .---._...
_--_
Signa re o wne / Lessee ontractor as Agent for Owner
STATE OF FLORIp/4�a�O
COUNTY OF ����
Swor to (or affirm�d) and subscribed before me of
Cat 4
L Physical Presence or Online Notarization
this 7 day of Co i� � by
�2/0
Name of person making statement.
ZOR Identification
Personally Known Produced
Type of Identificati n Produced
(Si ature o tary Pu lc- State of Florida)
" P ..,, IAMES MORSE
'=
_-
MY COMMISSION # GG 145457
Co mis ' No. (Seal)
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E(pIRES:November3,2021
;�:
'F?F°P'`
Bonded Tbru Notary Pubfic Underwmters
REVIEWS FRONT ZONING SUPERVISOR PLANS
VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW
REVIEW
REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 5/2U/Z1