HomeMy WebLinkAboutJames Rd 7507, Permit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
O ��-
LF - 20 °' , W. Tt1 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: _15 ()--I -�a r�(),E!�� (L6 I
Property Tax ID #: 1 ". o ` - (TO I - W q --'5 - 006
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
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New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Lot No.
Block No. l�
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 �% �Z Pitch
Total Sq. Ft of Construction: 2-8 Sq. Ft. of First Floor:
Cost of Construction: $ I .Lk S Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name$ \
Address: ��l%-1 �r.���
Name: ( t
Company:-T_o1Md_A_
City: \ Q fC _V_-- 1_"L State: -
Zip Code: �tS-i Fax:
Phone No. -I 0 b" - V `5 E-
Mail:
Address: (a '� T
V \ �79 2 -��5
��
City: r �} \tf C-�- "�
Stater_
Zip Code: '3` `G1�1 Fax:
Phone No 1i L- -
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail )LQ0+Y-c�c� r� m✓�d j
State or County License ( C C b 5 l '>c( q
e-OUV U1 «JUFc, a nm-unucu rvorice or commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER ENGINEER: _ Not Applicable
Name:
Address:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
Zip: Phone:
V VVIVCK/ %.V11V1 KAL I UK AttIUVI I: 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 consu t with your Homeowners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, 1 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 rope rty. A Notice of Commencement must be recorded in the public records of St.
Lucie County and p ed on the ' site before the first inspection. If you intend to obtain financing, consult
with lender or an tornev nrP rnmmPnrLna..anmrk nr rornrriina „n] it Aln+i,- of ! ".,�.,..., . .
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Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDq� , i
COUNTY OF `�—
Sworn to (or affirmed) and subscribed befgrp me of
O this 'er day of , 20_by
Physical Presence or Online Notarization
"M k r, P � -�(, ) LA-1v-
Name of person makin7sta ement.
Personally Known OR Produced Identification
Typ of Identification Produce
r
(Signature of of Notary Public- Stakd of Florida)
VT
1 1 I �Pi)`J 3� Sea1
Commission No ( )
FELICIA LYNE WILKIN
_��: Notary Public State of Florida
;". Fa; Commission # HH 160538
My Comm. Expires Sep 4, 2025
Bonded through National Notary Assn.
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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