HomeMy WebLinkAboutPursuit Tooling Building Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date : Permit Number :
P 11 C111 0 1 ° n 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 :
PROPOSED IMPROVEMENT LOCATION :
Address : eL S44 l U 0 4 Mud . po , 4 Pierc %c f l ffTa - c%
Property Tax ID # : ILA301 0A11 - ova - o00 - (, Lot No .
Site Plan Name : (� � r5 � :� �r.,�.( s �1na � S � a � L410s , Tj Block No .
Project Name : rur5y ; Toel , 1, R 1Q ; `nL ; na
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 Roof %_ � Pitch
Total Sq . Ft of Construction : 96 ,jam Sq . Ft . of First Floor :
Cost of Construction : $ /� .30 , �1/� • Oo Utilities : % Sewer _ Septic Building Height :
OWNER/ LESSEE : CONTRACTOR :
Name PQ mldcb , LLC c c ` L%p " g5bV, Name : _ D01 I (. s I) CW1 s
Address : 32o4 5 . . Lue. ; c i31 .. d . Company : _ Q , c\o\ a t� . �•r � s CZ. 54,rL) d1\x , Carr ,
City : r� � b Q� en .t State : F1 .. Address : 'Aloig fkvcizz. te 1), 4 .
Zip Code : 3 49 �I b Fax : City : } . � � ecc.e State : f�
Phone No . 772 - >�03- 6 �06 E - Zip Code : "3 ' A9 `{ + Fax : 14a � yb5 ' 71� (0 5
Mail @ j6A4&,e, Q19 & ,',perm// f�oa er. coffin Phone No
Fill in fee simple Title Holder on next page ( if different E - Mail r a ro c5i E ckaav �c . (Iw,
from the Owner listed above ) State or County License C (KC 6 13 0 4
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 : A . OD n a. a : o Name :
Address : Loq i 1ty 54o,, ,J Address :
City : Very %3eccL , State : F1, City : State :
Zip : j zy 40 Phone ; 3 2 q y � 4 ? 2 9 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 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 attorney before commencing work or recording our Notice of Commencement .
Signature of Owner/ Lessee/Contractor as gent for Owner V,tz 6ay)W46ree
STATE OF FLORIDA
COUNTY OF�.�T
Sworn t or affirme and subscribed before me of ✓ Physical Pres
this,V�day of N6V• 201/ by ;o�►�YPUe — ROGER A . PRIEST
' Notary Public - State of Florida
�/� Commission # HH 19924
iZUli,� SO/(/ dG f �YV My Comm . Expires Nov 7 , 2024
Name of person making statement ,
one r
Personally Known ✓ OR Produced Identification
4Typeoftification Produce
00000
of Notary
Pub i & State of Florida )
Commission No . ( Seal )
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 5 / 20/ 21