HomeMy WebLinkAbout9636 CROOKED STICK LN, PSL, FL. 34986 SLC UPDATED PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a
Permit Number:
�� ����
O `�
� � � ° � � � Building Permit Application
Planning and Development Services
BurldingandCodeRegulationDivision Commercial Residential '�
2300 Virginia,4venue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: � � n , i� � � �,� ����
PROPOSED IMPROVEMENT LOCATION:
Address:
Property Tax fD #: - - I - Lot No.�`
Site Plan Name: �b01 t U N -I {- - 1 Block No.
Project Name; � i ti
DETAILED DESCRIPTION OF WORK: Si �� �e C.i r� A��Or✓l�-E,
1;
New Electrical Meter_ Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
Mechanical
Electric
^Gas Tank
Plumbing
Total Sq. Ft of Construction:
Gas Piping
_Sprinklers
Cost of Construction: $,���, �C�
Shutters � Windows/Doors Pond
_ Generator � Roof Pitch
5q. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name:
Address:Q�p�o C_Ccx�XQ,(3 S}►c 1C._Ln,
Company: � ,nlCri � `
City: �[ � S� . L�,t.C_�� State: �
Address: — 1
Zip Code: ��/�b Fax: I'yi4
City: � � ��-, �,�C i 2 State: ��
Phone No. �l i� '"' �103 � S4�t `
Zip Code: � �g% Fax: ��?-$� l-���
E-Mail: A�rv►�i�SCa�D�n�tcxv`tit�„� nl�►�Ir�e�r'_ c corn
Phone No R�
- -
Fill in fee simple Title Holder on next page (if different
E-Mail �r,,�;� � �, cx.,�1C.t; `„�
from the Owner listed above]
State or County License -C
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 C�NSTRIJCTlON LIEN LAW INFQRMATION:
DESIGNER/ENGINEER: ]� Not Applicable
Name:
Address:
City:
Zip: Phone
State:
FEE SIMPLE TITLE HOLDER: ,Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: � Not Applicable
Name:
Address: ._ _ - ---.
City: State:
Zip: � Phone:
80NDING COMPANY: Not Applicable
Name:
Address: __.__
City:
Zip; Phone:
OWNER/ CONTRACTOR AEFIIdVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
l 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
s r�ucture�Pleasecco salt uvfth yourNome Ow�ers Assoc,a on and review your deed for any restrict ons whichtmay applyhlblt such
Inconsideration of the granting of this requested permit, f 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 roams and accessory uses to another non-residential use
WARNING TO DWNER: Your failure to Record a Notice of Comrrtencement may result in paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucre County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorne before commencin work or recordin our Notice of Commencement. __
Signature of Owner,
STATE OF FLORID
COUNTY OF �' u U G
5y►grn to (or affirmed) and subscribed before me of
✓ P ysrcal Presence or Online Notarization
this ,� day of h�.:#�hc�1C' . 202� by
�y; c� 17�.��
Name of person making statement. /
Personally Known OP Produced Identification
Type of Identi ication
Produc�e/d1 -y�
[signatc�# 1, � un1�6u���I�E�diht'W° �
Notary puhNc • State of Florida
.' " Commission K HH 49871'62a1
Commissi }
k„.�h,;.• y omm. Aires Qct 1, pI4
"Bonded throagh National Notary Assn.
REVIEWS � CD �NTER I REVI W � S REVREWOR
DATE
RECEIVED
DATE
COMPLETED
ev.�%G7��
Signature of ContractorJLicense Holder
STATE OF FLORIDA �. .
COUNTY OF � t � u u Z ---
5wq+�n to (or affirmed] and subscribed before me of
✓ Physics! Presence.or Online Notarization
this � day of 202� by
1VI �7r IiC�C.
Name of person making/statement.
Personally Known �/ OR Produced Identification
Type of Identification
Produced
,�t,�,i,u.�'i�c Ga��-y.
(Signat`z4 f a r F' n c- [ r •vr rror iue
:,��ir'►u••: lULIE JANE �ICCAULEY
Commis ��otary Publie State of Florid al)
�_'�" `= Commission � HH 49824
'�;ov n.�� My Comm. Expires Oct t, 2014
PLANS VEGETATION SEA TURTLE MANGROVE `
REVIEW REVIEW REVIEW REVIEW _._
.�