HomeMy WebLinkAboutSpencer Building Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
.t
s - 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:
PROPOSED IMPROVEMENT LOCATION:
...1 :,,r 4; ��r 12. c1ti"- _ s>la.tr �-i �.,d tiv r•�•ri
Address: 1(r 3 G• o u it„� w "lt]u Sri C rite 4�G L C F L 3`l 'q c -- ✓ I I I L, R L am} I H / (>Yr- 1 k^ I v
Property Tax ID #: ' "-12Ln -`IU u S - c a c> - Lot No.
Site Plan Name:
Project Name: `S im_e'-,
Block No.
DETAILED DESCRIPTION OF WORK:
71 r% C e f -1 n Sur c•. V2, I -t V'� U,_J [•Vv Icy �� i(e r-
b0 -A .rye 2 d rtr7c 1 r2 S- A, ,.
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
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ (o ,
OWNER/LESSEE:
(Affidavit required)
Generator
Sq. Ft. of First Floor:
Windows/Doors ` Pond
Roof Pitch
f r. Utilities: —Sewer —Septic Building Height:
Name Cc r-& 1 t vYi i' ia'wn e- `7 ,2-r ",I C .-
Address: I�o3(n u-) �x,+-vov\(o h '
City: C, 1 w\ C State: �
Zip Code: Fax:
Phone No. �' c '� 1tl - S ', &
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
Name: _ � S i�j i3rz�k:r�
Company: C,QLAY-,,C LLB
Address:.33`:Q_ n
City; State: �-
Zip Code: Fax. r� -1 - J0
Phone No &�l it SfLoj-ko"%- 5 3
E-Maii b 5'."33 C'�
State or County License 0.�.,l I �_
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:
DESIGNE
Name:
Address:
City:
Zip
UINUK: _ Not Applicable
Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
State
Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone: _
Not Applicable 1
State:
Not Applicable
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 attorneybefore commencing work or recording your Notice of Commencement.
,5*afdre of OwnerrLessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me of �ysical Presence or _.._ J Online Notarization
this-t2f'davof 202-1 by
Name of person making statement.
Personally Known E_--�OR Produced Identification
Type of Identification Produced T 1u '�r ".-tom s t_� CA N
(Signature of Notary Public- State of Florida)
Commission No&C- 4fi t 1 oQ I (Seal)
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
KAREN CODERRE
MY COMMISSION k GG 981001
EXPIRES: April23, 2024
Bonded Thru Nutary Public underwriters
SUPERVISOR I PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW I REVIEW REVIEW REVIEW REVIEW