HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:'A N-N
9U.LUCE RECEIVED
OCT 12 201,
Building Permit Application St.Lucie Pe County
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:
TO.N PROP.,OSED,,IMPROVEMENT�,LbCA'T '.�..
Address: qqq-o 0C,,q01, D^. 11 pl --q!57-
Property Tax I D#: —044 Q _0�1 Lot No.
Site Plan Name: Block No.
Project Name:DETAILED
P-� 5
T DES
CRIPTION
L /I ko d-4 c4 e c,iianep occ�-
New Electrical Meter Second Electrical Meter (Affidavit required)
INFORMATION
iTRU
Additional work to be performed under this permit—check all that apply:
—Mechanical —Gas Tank —Gas Piping Shutters Windows/Doors Pond
Electric Plumbing —Sprinklers Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ Utilities: —Sewer Septic Building Height:
-'CONTRA CTOR
Name 0 eQ-Aa 0_F_
cm old Name:
Address: q(4 L,-b 5 Qce4n Dr,. S- Company: �Oct Reno Pine -2:t
City: A Jen Q Qci(A State:),--L Address:-Lt3T
-3 -2 fZol+ p'e--c
Zip Code: " L-IL-Oi S Fax: City: -10 State:E
A,Gl- qoq --)a-
Phone No. .2,7 —E- Zip Code: Fax:
Mail: t!�a ra6,�,i t-,3-61(a)- C4pV,"J_ 'CO�3 Phone No _77ME2_—�5-1?k
Fill in fee simple Title Holder on next page(if different E-Mail S'Oiq-M bwcA ac Ug
from the Owner listed above) State or County License CAC &
/IV 20 -7/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-'CONSTRUCTION .LIEN LAW°INFORMATION
DESIGNER/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 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 attorney before commencing work or recording our Notice of Commencement.
c
Signature of Owner/`_Cessee/C&drrctor asA#flt for Owner
STATE OF FLORIDA
COUNTY OF F U 1 '6 C
Sworn tg(or affirmed)and subscribed before me of ✓Physical Presence or Online Notarization
this-, "bay of CX— ,20_,9J by
VN c V QG,S
Name of person rhaking statement.
Personally Known OR Produced Identification
Type hf Identification Produced 4::L DL.L
At
( i a ure of Notary Publi - tate of Florida)
Commission No. 2-"g 114 (Seal) LATASHA CAREY
MY COMMISSION#HH128114 4
b oF� EXPIRES:May 10,2025
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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