HomeMy WebLinkAbout6108 Sunset BlvdAll APPLICABLE INFO MUST BIE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: la-Q 7 Zl Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fart Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial
CBDG Funding
Residential
PERMIT APPLICATION FOR: �'�� 6�i'1
PROPOSED IMPROVVEMENT LOCATION: �� /�/
Address: D l�� V�/i�L'� �ll/� �� f !" talrGC'. 6�J .� �cf�'oZ
Property TaxlU#: �7 �QGi�' o� J"'U6 !Ia' ���� !
Site Plan Name:
Project Name:
Lot No.
Block No.
DETAILED DESCRIPTIDN OF WORK:
��?D �e M�rsfer l �fh tuh end panyeY� �a sh�r.��r. /�'la�e d �-�r�
d �ns�a // s ewer �r� end .S'r'r� �e ���rc1�e ha wer v�lr��_
�un -3/�" �?07` (iVCtfe�- %i�1� ��a� �c�er �e�fer to �t�ste�-6��hroe�t
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check ail that apply:
,Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric Plumbing _Sprinklers _Generator _ Roof
Total Sq. Ft of Construction:'' II 5q. Ft. of First Fioor: _
Cost of Construction: $ �, 7�d � _ - ___ _ Utilities: _,_,Sewer � Septic
_ Pond
Building Height:
Pitch
OWNER/LESSEE:
CONTRACTOR:
Narne ` ! G'f Zb
Narne: r � Z�n�`�a
Address: ���� �lf/15�� �IVd
Company: Of-'7fu.Sf• ,LLlG�%e GP�-1 ��g
City: rT ��er� � State: `L
Zip Code: ����a Fax:
Phone No. �%d �4a ' d� �� E-
Address: 6 g0 ` F7�il.fQ�l~ �r �
City: {ESL State: FL
Zip Cade: .3�95 � Fax:
Phone No 7�� _�p�z
E-Mail f I u.� �e v uM l � P c�M.a� �, cr��
Mail:
Fill in fee simple Tstle Holder on next page cif different
from the Owner listed above)
��rfs
State or County License C �C d 5 a 2'y
!f value of construction is 2500 ar more, a RECORDED Notice of Commencemen# is required.
if value of HAVC is $7,500 ar mare, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTfON LfEN LAIN fNEORMATION:
QESIGNER/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 wvrlc and installation as indicated.
l certify that no work or installation has commenced prior to the issuance of a permit_
St. Lucie County mattes 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 afthe granting of#his 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 fuH concurrency review: room additions, '�
accessory structures, swimming pools, fences, wa1[s, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Retard a Notice of Commencement may result in paying twice for
improvements to your property. A Notice of Commencement rust be recorded in the public records of 5t.
Lucie County and pasted on the jobsite before the first inspection. if yc�u intend to obtain financing, consult
with lender ar an attorney before commencinl? work ar recardin� your Notice of Co►rEmenr_err�ent.
5ignat r f erf L efContractor as Agent far Owner
STATE OF FLORIDA
�� �fitCle
COUNTY OF
Sworn to (or affirmed) nd subscribed be��e me of � Physical Presence ar Online Notarization
this �,,,, day of ZO_ by
j j
Y � � i la
Name of p�rson malting statement.
�
Personalty Known OR Produced Identification
Type of Identification Produced
(Signature of Notary P � �c� State of Florida]
x Cole�.�GG3B 65$
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Commission No. t7�.�� Q �JF� (Seal) s� �: �; � ��
''---,,;;�„ •,a Bonded i1llu Aaron rotary
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