HomeMy WebLinkAbout5511 SEAGRAPE DR, PSL, FL. 34982 SLC PERMIT APPLICATION�11I° ilk, �1e� ib SLC
All f ..'PLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: A� Permit Number:
�= [LUCIl�
0
° ° p 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
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address:
Property Tax ID #: D - - 0051 - 000- q Lot No._3_�C_
Site Plan Name: T �c.n �� �c5 ; 0� 4� 0 C vWp 31J1J I Block No. 3_
Project Name: �1( �VA� `
DETAILED DESCRIPTION OF WORK:
_ 1 n A A In I r�7�ri�n/1
New Electrical Meter Second Electrical Meter
1
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
_Mechanical — Gas Tank —Gas Piping ! Shutters -Windows/Doors Pond
Electric I Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ L.21-s' oc) Utilities: ^ Sewer _ Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name `:� � ► �e Name:
Address: � Company: m vl
City: State: Address: L, L-IC CiC►-
Zip Code: ���� Fax: �'aZ - r 1 City: `b J�• �e State: t�L
Phone No. vZ- a� Zip Code: N99bFax• a Srfl-Ra6 .—
E-Mail: War" am,,t 4 Dt hOD, Phone No VA _5rf 1-94gl(
Fill in fee simple Title Holder on next page ( if different E-Mail n"'wer, corm
from the Owner listed above) State or County License C'-r`C�# �y3 L)(13-7
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.
CTION LIEN LAW ImPoRMAT}�N;
SUPPLEMENTAL GpNSTRU Not ca
Appli.bie
_T
Name:
Address; State'.
No pA pliable
MORTGAGE COMPANY'
Name -.___-—State:
Address:
City. Phone:
I Zip. licabfe
City, Phone Not App
Zip: licabfe BONDING COMPANY:
Not App Name'. 1
FEE SIMPLE TITLE HOLDER: -� Address:
Name: city:
Address: phone:l_ _
City; ZIp.� ��
Phone:
Zlp: rrlade to obtain a permit to do the work and installation as in
.
Application is hereby permit. subject structure
OWNER/ CONTRACTOR AFFIDVIT: App prior to the issuance of a p prohibit such
1 certify that no work or installation has commenced p a ermit will authorize the permit holder to buildrestr c tar
restrictions which may apply -
makes Lucie Count makes no representation that is granting
anon and review your deed for any erform the work
5 yy n a pliable home Owners Assoc+at+on rules, bylaws or and covenants that m
which is in conflict with a y pour Home Owners A agree that 1 will, in all respects, p
structure. Please consult with g permit, I do hereby g
In consideration of the granting of this, t nested
with the approved Plans, the Florida Building Codes and St. full+Goncurrene county cy review: room additions, ential use
in accordance t from undergoing a
permit applications are ex signs,
uses to another non-residential
The following building p Dols, fences, walls, signs, screen rooms and accessary rest:lt In FaYinR twice for
accessory structures, swimming p corded in thpublic records of St.
A Notice of Commencement m�s�fbe uintend to obtap financi �g,
consult
WARNING TO OWNER: Your failure to Retord a Notice of Commencement m n
improvements to your property.,
Lucie County and posted on efore bcommencin tworkSt inspection.
our. Notice of Commenceme
with lender or attorneyb
of Owner/ Lessee/C tractor as Agent for Owner
Sign
STATE OF FLORIDA L1
COUNTY OF
Sw rn to (or affirmed) and subscribed Line fore r nation
e Of
11 Physical Pre ence or a No ri
this j•(3 _ day of '+
t)
Name of person making stat meat. ,
Personally Known OR Produced Identification
Type of ldentific tlon
Produced�i
(Sign4ftur
4 JULIE JANE MCCAULEv
• Notary Public State of Fl�q
Commissi HH 4981k
My Comm. Expires Oct 1, 2024
REVIEWS _ tCO FRONTN ER REVIEW W NING 1 S REVIiEWDR
RECEIVED
DATE
coNAPLET
or reco
Signature of Contractor/License Holder
STATE OF FLORIDA 1,V1 67T
COUNTY OF
5w rn to (or affirmed) and subscribed be foe me
Of
hysical Pres nce or Z020 by
this �l} day of
Name of person making statement.
Personally Known VI OR Produced Identification
Type of identification
Produced
�;a! JULIE JANE MCCAULEY
Notary public - state of Florij I
Commissi ` iisierrd HH 49824
o' My Comm. Expires Oct 1, 2024
PLANS I VEGETATION I SEA TURTLE I MANGROVE
REVIEW REVIEW REVIEW REVIEW _.