HomeMy WebLinkAboutWhitehouseRichard PermitApp18OCT2021All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �otz� 1 Z 1 Permit Number:
° Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial X Residential
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: fv)-� nkttt 1 �,,, � Yt+%Yll
Address: +J q ,ti k 4 ( . V-4o 4'
Property Tax ID U 00r15— 000
Site Plan Name: [� ytL A h I C rykAo V46\
Project Name:
New Electrical Meter
Second Electrical Meter
(Affidavit required)
Additional work to be performed under this permit- check all that apply:
_Mechanical — Gas Tank —Gas Piping _ Shutters
)' Electric Plumbing _Sprinklers _Generator
Total Sq. Ft of Construction: 6 Sq. Ft. of First Floor:
Lot No. -
Block No.
Windows/Doors — Pond
Cost of Construction: $ ,e�-o0 t� Utilities: _Sewer _Septic
NameZ1� IiY� w
Address: 1�v u S QctA•-
City: �CY)SUI A- . _ State: .FL
Zip Code: S-+ Fax:
Phone No. -1 3 - Doe - -7,$ 1,4 E-
mail: '-
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Roof Pitch
Building Height:
Name: C nt4t3 Lo ud4L)
Company: Vla✓ v&) tqw-U
Address: A61- 0 yntL-vi.tta A
City: i w , C,i-. State: l
Zip Code: 4GI l Fax; • —
Phone No i 33a - 61("68
E-Mail C1oweC(tc.tr�c+ntC_'a aol. C��^
State or County License [C .` 3C) 1 C) 8 4-0
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.
DESIGNERANGINEER:
Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name:
_
Name:
—m_
Address: —�,
State:
Address: _
City:
Staten
city:�.-_,
Zip: ,-- Phone____
Zip: Phone:
--
FEE SIMPLE TITLE HOLDER:
7C N.t Applicable
BONDING COMPANY:
of Applicable
Name:
Name: J_
Address:
__ ___
Address:
--
City:
_
City:
Zip: Phone:
_.
Phone:
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wnrle mnri inctallation as indicated.
K
OWNER/ CONTRACTOAht•IUV11 : Applicauw Oon is hereby inaue UL01" a N=-
I certify that no work or installationthas 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 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 attorne before commencing work or recording our Notice of Commencement.
l �
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF� t VIGa�
Sworn to (or affir d nd subscribed before me of Physical Presence or Online Notarization
this day of r 20 Z ( by
Name of person making statement.
Personally Known OR Produced Identification
Type of identtifiRtion Produced ._
(Signature of Notary Pubic- State of Florida)
Commission No 2', (Seal)
4P,�°cr, Notary Public State of Florida
`F Sabrina M Arrington
+� My Commission GG W8279
Expires 08/27/2023
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERV SI OR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
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DATE
COMPLETED
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