HomeMy WebLinkAboutApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10 - Z(o - Zo 2-1
Permit Number:
gOo
V 11MWnT-U U0 4'�— Building Permit Application
Planning and Development Services ^^ ll
Building and Code Regulation Division Commercial Residential L�
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: Re - \2, p cic
PROPOSED IMPROVEMENT LOCATION:
Address:1[)ab% 5 Doan PY, 650 T- nSeri t3eoxc\ FL, 3#g6�L
Property Tax ID #: 1451) - 2rOS -(Do SA- OD/D - Y Lot No. 51
Site Plan Name: TI )S4ZA W.,7-1e1-01d1/I17 Block No. N/fl
Project Name:
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
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 "oof 21/2- Pitch
Total Sq. Ft of Construction: 110i) Sq. Ft. of First Floor:
Cost of Construction: $ 10, 260. O O Utilities: _ Sewer _ Septic Building Height: t7-1
OWNER/LESSEE:
CONTRACTOR:
Name Su5VY') Wa-IeJ-z.VlA/J
Name: 7ylce 1al-
Address: 10 -701S c)6Cr2/I b I- 6SO
Company: t � � T 2
City: :m25&9 %3e eGA State: FL
Zip Code: 3Hg5 � Fax:
Phone No. /1//14 E-
Addresss:31AI0 SE LLIO JP/' .S4
City: S4uoly State: FL
Zip Code: �Wqq�7_ Fax:
Phone No Z- g-Z- FS03�
Mail: /I//'41
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail &o2;/_5&*Af "ela/ry0&% e ' ntf
r �
State or County License CCC_ 133 z3yb
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 I:LNN -- Zip: Phone;
FEE SIMPLE TITLE HOLDER: _N Ap ble B DING COMPANY: _Not Applicable
Name:
Address: Address: 1
City: City:
Zip: Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Appilcatlo is h y`Q1ade to obtain a permit to do the work and installation as indicated.
icertify that nowork orinstallation hasco elect of theissuonceofapermit
St. Lucie County makes no re msematlon t nti ape it will authorize the permit holder to build the subject structure
which confifcts with an app �pble Homeo ers da 'on rules, hylaws or aSIJ1d covenants that may restrict or prohibit such
structure. Please consult wrt� your Homeawn Assn nand review your tleed for any restrictions which may apply.
In consideration of the granting ofthis requ permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Flo 1p dingCodesandStLucleCountyAmendmetits
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 party. A Notice of Commencement must be recorded in the public records of St.
Lucie County and or r d a the jobsite before the first inspection, if you intend to obtain financing, consult
„r AV hefnw rnmmwncinc work or recording vour Notice of Commencement
_•......._ . _. _ _ _...- -- - ------------- - -
51 wner/Lessee/Contractor as Agent for Owner
TATE OF FLORIDA �—_^-,
R�7,
COUNTY OF rf+� r�Y) !� /
Swam t(a oraffirmedjand subscribed before meof _,PhysicaiPresence or —online Notarization
"
this��day of !X T 202-1 by
Name of person making statement. i
i
Personally Known _� OR Produced Identification
peo IdentificationPro dsted
S Lure of Not6fy Public- Stat1fof Florida
Co mission No.4 7 f r {Seal) I Jototy Pubb Stele of Floriae
Maria A, Nolina
Commissico GG 211062
'exprtes a4l2512022
REVIEWS
FRONT
ZONING
SUPERVISOR
t
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev b/ZU/Ll