HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED_- �'7 d ��
Dater � � �� Permit Number: : / �.
REG
211. I U),CL 0 10A
K,town,
Building Permit Application Qe�st U10eco
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
PERMITAPPLICATION FOR:
PR®POSED IM,,F �EM�ENT LOC�A�TItON` ¢
z OU
Address: �!5t _,YTIJ
Property Tax ID #: 7J�� Q�D�. 0�� Lot No.
Site Plan Name: L�%Q/ . �PSFI�u �r1'iG/t °v>s� Block No.
Project Name: l94A- Q J .
New Electrical Meter Second Electrical Meter (Affidavit required)
CON`STR�UON'� NF�®RMAI'10N
,�- �.__�r__
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: ` I�'r'D Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: _ Sewer _Septic Building Height: ,
OWNS-R%LESSEE:
,CONTRACTOR
k
Name 17.0414 VIS10,/n
Address: ,5�{/Sl1n ��lV Syok--*�50
Name:
Companyl—VO I
�
City: Cj0 l4�/ l�
State: _'
Address: / /' V. l%4 #(
city: �yl, .Sta_te:
Zip Code: I Fax: -';CS 604*- 1S
Phone No. 6&6?- Pl qi�
ZIp.,Code ,1"ax " y _
PhonerN.o- r==5'S _. !off
E-mail:' 1AT% L N�'i 5%
,l � �► �4t-�.T�4' �.Ma� � •Cast • .
Fill in fee simple Title Holder on. next page ( if different'
from the Owner listed above)
State or C ounty Llcerlse G
It value of construction is 2500 or•more, d RECORDEDfNatic
If value of HAVC is $7,500 or more a REC0Rl5ED Notiee of:(
�,'• ��
nent'i§.required
is r
¢
f
SM
W ON LIEN INFORMATION
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: of Applicable
Name:
Name: —141
Address:
Address:
City: State:
City:, State,
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: :5ANot Applicable
BONDING COMPANY: Not Applicable
Name:
Name:.
Address: a
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 is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners 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 afull 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 attornbefore commencing work or recording your Notice of Commencement.
Signature of2gr-, r/ C ctor as Agent for Owner
STATE 0 LORI
COLIN OF (01,n.._
Sworn to (or affirmed and subscribed before me of hysical Presence or Online Notarization
this _U day of 20 7 -11 by
0
Name of person making statement.
Y
Personally Known OR Produce entification
Type of Identificati n P o uced-
(Signature of Notdftublic- State of Floda
ANNARELLAACCION
Commission No. (Sea[) M: Notary Public -State of Florida
Commission # HH 038085
My Comm. Expires Aug 31, 2024
Bonded through National Notary Assn.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
iev 5/20/21
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EXHIBIT "A" PRIMA VISTA CROSSING LEGAL DESCRIPTION
The North 442.78 feet of the South 2,385.78 feet of Southeast/4 of Section 22, Township 36 South, Range 40 East,
Lying East of US Highway No. 1.
EXHIBIT "A" PRIMA VISTA CROSSING LEGAL DESCRIPTION
The North 442.78 feet of the South 2,385.78 feet of Southeast'/4 of Section 22, Township 36 South, Range 40 East,
Lying East of US Highway No. 1.