HomeMy WebLinkAboutBUILDING PERMIT APPAll APPLI ^C U`ABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I y e m 6�(- 3, 20 21 Permit Number:
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rL I L> `1-.� - 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: Plum k n ,
PROPOSED IMPROVEMENT LOCATION:1
,ririraec• 7G;:��.. l� �'C','�i C)f�� e; - C, ('GIC
Property Tax ID #: 3322 `700
` n M ' OCC
- �_
Lot No.
Site Plan Name:
- Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
t aCs_- -r2c, u.'O o
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
_ Electric /Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction:
Cost of Construction: $ l jo( r, ,00
_ Windows/Doors — Pond
Sq. Ft. of First Floor:
— Roof Pitch
Utilities: _Sewer ,Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name 10 ee 2 1 ('i Cc�>mC, �
Address: .1 � t � llt C_cn 1> (
n
City: /'lone-ot_ State: / ,5
ZipCode: 0 Fax:
i
Name: e 1,6
Company: 0rf R �f e'. u
Address: 26Z e 't r
city: ��}} t
tY- il��� i"� L�,cle State: F4
Phone No. 7 "Z - �' 3Z� E-
Mail:
Zip Code: 34i5l Fax:
Phone No 77o7- 46 65e_
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail F "
State or County License C FC ote ibd 5
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: Applicable
Name:
_Not
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
C1�AlMCD/ /`/►1►ITDAf"'e'An Arr•w•T_ _
-- -- •-•-•�� •.. VN'% rwrwv i 1: Hppncation is nereoy 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 attornev bpfnre rnmmanrina wnrle r,r rarnrAinrr „l. ki„t:, - -.r .-
-....w... .,... 1.WL1%.0 U1 vnnuc�i�Crnenc.
Signat r f v er/ Les a/Contractor as Agent for Owner
STATE OF FLORIDA,- I
COUNTY OF 5T, LRCI e
Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization
this``_ /i day of oVeE . � b(f c- . 202( by
f r ff
Name of p4 rson making statement.
/
Personally Known OR Produced Identification
Type of Identification Produced
(Signature of Notary P 0fic- State of Florida) a
s Commission No.0. i4JT9 (Seal) Comm.#GG3 658
Expires• Aupd 25,20
�''?%�;,,•�°'� Bonded
Tel Aaron ftry
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