HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: S - I o " Z t - - Permit Number:
-r. LUCIE
V?RT-Y
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
RECEIVED
AUG 2 5 2021
St. Lucia County
Pe"nitting
Residential
PERMIT APPLICATION FOR: �sv►.t� .} Inr���X?. �s•.►�vrrtta�s
PROPOSED,IMP.ROVEMENT LOCATION;
Address: 13; 0T ►.ICJ w,oy- w)yjL-rL.6 Tf�,oiL, , pi3k-,M C qi (HOO&Sav2. ex0uc)
Property Tax ID #: q q3(0 - (00l - 0021 - 000/9 Lot No. 21
Site Plan Name: N A Block No. FIAT o
Project Name: GALLO 76S1P6*"J .6 fzF-J10,jAT10.)
DETAILED,DESCRIPTION OF WORK:
Sc6P6 aF t,,-*e1e_ l.irr5o o-i Pt-o•Jl To 1,JGLU06 P- PLu0Gbn,s•✓r of 691s•r►a4 DOOV-
l'JIn1pGvJS /'�tslP SYST�i'`'tS AMO �n/Ts+2►o41.. �'►^!1$i.16S -
New Electrical Meter Second Electrical Meter.
CONSTRUCTION: INFORMATION.
(Affidavit required)
Additional work to be performed under this permit- check all that apply:
mechanical _ Gas Tank _ Gas Piping _ Shutters k"' Windows/Doors _ Pond
�i ir'6
✓_ Electric _✓Plumbing 1_ Sprinklers _ Generator l�Roof VGPL4csn+v^ r Pitch
Total Sq. Ft of Construction: 317Z$ r� Sq. Ft. of First Floor: 3. 72$ 17,,F48 7-ar,01-
►
Cost of Construction: $ lobo, 000• Utilities: Sewer , _Septic Building Height: 22
.OWN,ER/LESSEE:,
CONTRACTOR:
Name Z7omus jic &ALLO
Address: 134t Z (umir 4-13) 1-442Qoy&F-066' F3L1fV
City: 'P n �- �- `TY State: F L
Zip Code: 3`t99O Fax:
Name: (7RF6 Of-I>,0 idJ5Y,%
Company: got" CaJsw-j rrri.J or
Address: ?, O • Y?6Y
City: s'i'% State:_EL
Phone No. -i'lZ- 33c-- 71k0
E-mail: 6 z6-te_ 60.0--061PL. <,O^
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Zip Code: SYM Fax:
Phone No -772- 33G - 7Zyd ?7?- -SZS -$SF3 2--
E-Mail �7�ty20MDli FC' �r►'t'
State or County License C6rQ S6S127 SLCC - 237Z
If value of construction is 2500 or more, a RECORDED Notice of commencement is requirea.
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: A&u4ITECT01.AC , J.uC.
Name:
Address: BOG vk Aw,on6 01.6 •
Address:
City: Pr. P.i c&x,e' State: L-
City: State:
Zip: 3q9s o Phone 792- q&a -77-v 1
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name: SIO M6 As o.ur.lt L
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
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
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 your Notice of Commencement.
Satire of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF ST - Uuue7
Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization
this Z?'day of AJ401' . 20 M by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification Produced
(Signature of dhary Public- State of Florida )
1 �7 Nowry Public Stag of FkMa
Commission No. t v L Seal) Q0, a AmyE.Scott
My Comm�tan HH 124378 .
a Exgms o5102in
REVIEWS I FRONT I ZONING
COUNTER REVIEW
DATE
RECEIVED
COMPLETED
SUPERVISOR I PLANS I VEGETATION SEATURTLE I MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW