HomeMy WebLinkAbout5966 Travelers Way Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: II I'-1 I Permit Number:
`1, LLLLL
.Y•
F: ", . -- Building Permit Application
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: EleC��lC -�1C2 C1�1G1
Address: SER60 11'(XVEW S WC�&i j rOr� 2MC) FL_ SLIOI L3
Property Tax ID #: '�Iy IO ` 5O3 - 01n1 • 1m -a
Lot No.
Site Plan Name:
Block No. 17
Project Name: IN671►D 1C DAP
DETAILED DESCRIPTION OF WORK:
i� 1 �r i�"�t�ll(',1 cAnd hreakerS Same. SIzC�
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 _ Roof
Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: _ Sewer _ Septic Building Height:
Named O,r) WCV"ae_k
Name: RQui-�Cf
Address: DES (O�h
Company: E)AgmCic e1e(*f1C.
City: L ufU e.l State: .J!!�Ly
Address: �0 i:Z'0)( '7?>0'-_
City: Porgy- SA- U.ICle
State: rL_
Zip Code: 11,gL4 g Fax: '�
Phone No. L0:,�I-'I01 - L4ssq E-
Zip Code: Fax:
i-
Mail: hl�� aq��Qf-xG I -cops)
Phone No i1a- S31 -oOSS
E-Mail (QQ
I1 -wry )
Fill in fee simple Title Holder on next page (if different
State or County License EC-1-1wM0
from the Owner listed above)
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 CONST:C
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
Zip: Phone:
City:
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)obsite 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.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF '4 L!<,l00- /
Sworn to (or affirmed) and subscribed before me of ✓ Physical Presence or Online Notarization
this day of Ite�i( ��, 20al by
uor - ��cm�
Name of person making statement.
Personally Known OR Produced Identification
Type_of,ldentification Prcduged
(Signature of Notary Public- State of Florida )
Commission No. q�� I'{� (Seal)
REVIEWS FRONT
COUNTER
DATE
RECEIVED
DATE
COMPLETED
ZONING
REVIEW
ALISON HANSON
MY COMMISSION # GG 970043
EXPIRES: March 16, 2024
Bonded Thru Notary Public Underwriters
SUPERVISOR PLANS I VEGETATION I SEA TURTLE I MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW