HomeMy WebLinkAboutBUILDING PERMIT APPLICATION_10132 INVERNESS WAY_BRYAN MARTINIAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
LLGLL
L" EL c F� ' ° IJ CaL, 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
PERMIT APPLICATION FOR: -:-SL, LDIIv 6
PROPOSED IMPROVEMENT LOCATION:
Address: 17d� �lni.�UYi'1G'L�� lr�l.':I �7_
Property Tax ID #: �� �� � �—uLot No. ��
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
New Electrical Meter
Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
Mechanical Gas Tank —Gas Piping _ Shutters
(Affidavit required)
Electric _ Plumbing _ Sprinklers — Generator
Total Sq. Ft of Construction:
Cost of Construction: $ i�Q" ' 0'O?
Sq. Ft. of First Floor:
{tea
Windows/Doors _ Pond
Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name i1tc4V-)` 7c•1c 1Y1' v+Lrr;
Name: <� ve-t22
Address: 1 C i ;3Lt.
City: t State: �-I.
Zip Code: � qq' S L% ` Fax:
Phone No.
E-Mail:
Company:,._3F ; io iw
Address: 12,1)1 >iz) ! I->"9?a a' C' S J-
_
City: 121 State: F L
Zip Code: 6y0'C0:;-- Fax:
Phone No
E-Mail f l/ l 0 5 `
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License
If value of construction is Z5ou or more, a KLLUKutu NOTIce or t.0mFHf4F1GCr1JC11L M I CHU ICY.
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
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: 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
Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
which is in conflict with any applicable
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
with lender or an attorney before commencing work or recording our Notice of Commencement.
Signature of wner/ Lessee/ ontractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF 5 %- L4z�-L
Sworn to (or affirmed) and subscribed before me of Zphysical Presence or Online Notarization
this ��� day of u c ro �366- 20_,21 by _)<.''-i rY 6<.h .3•r /.<-', Z
Name of person making statement.
Personally Known v°" OR Produced Identification
Type of Identification Produced_
L __ Notary Public State of Florida
Co fission No. (Seal) _ Stephanie Faye Doumitt
r Mmission
HH 166709
�o;�° Exp.8M9l2025
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10132 INVERNESS WAY
2
3
OPENING
SIZE
1
108.75 X 95.75 SGD
2
61 X 95.75 SGD
3
144 XX95.75 SGD
4
97 X 95.75 SGD
4