HomeMy WebLinkAboutSavanna Club Permit App- 3150 Crabapple Drive All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dater: It 11 I 21 Permit Number:
I �� �
CILE
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial X Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 CBDG Funding
PERMIT APPLICATION FOR: Itc
PROPOSED IMPROVEMENT LOCATION:
Address: 31 S a C-rajb 412U-, D yT.c
Property Tax ID#: 3L42S - 704 - Dot 2-- oGo - Z Lot No.
Site Plan Name: Block No.
Project Name: S/xu aM oa C 1__
DETAILED DESCRIPTION OF WORK:
gr�LL I s kyj I op A, ryv it Ion R 4"e
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: $ Z3 CC) — Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name S[.vr,�n C ulo Name: M r hni.l Pvi1A,e
Address: ?st 612 n 4 D - Company: Frio 1✓IcL f v .[l SLrv)Lz% of FL
City: P< L- State: -F- Address: 842� 5 k:�,hq< N+"
Zip Code: 34 A S -2- Fax: City: FL + P State: FL-
Phone No. E- Zip Code: 34,945 Fax:
Mail: Phone No -nL y iv I 7--ill
Fill in fee simple Title Holder on next page (if different E-Mail m i V-c 0 pr 0 - ate h-i
from the Owner listed above) State or County License F& 1300 - 555'l
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 prop A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted the j bsite before the first inspection. If you intend to obtain financing,consult
with lend r or an alto before commencin work or recordin our Notice of Commencement.
JIL:
SignAlGrOf cif Owner/Lessee Co ractor as Agent for Owner
STATE OF FLORIpq I �
COUNTY OF �1-
Sworn,to(or affi d and subscribed before me of ✓ Physical Presence or_Online Notarization
this da 20.2,k by
Z—OVld�
Name of person making statement.
Personally Known/OR Produced Identification
Ty entiflCdtlOn Produced
(Signature of Notary
y/Public-State of Florida)
Commission No. GA hiq (Seal) David Raymond Prue
NOTARY PUBLIC
STATE OF FLORIDA
Comrn#GG287052
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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