HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I Z I/A/ /ZOz/
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Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: RC , %LOOS
PROPOSED IMPROVEMENT LOCATION:
Residential v
Address: 5ri•(I ca,55:a DK '�-OV4-- A(q-ce )t7-L 3'fg25,�
Property Tax ID#: 3102- DOD—O Lot No. 3�
Site Plan Name: 6�,_V(j dd2uli L Z Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
R eDVG Sh;r ]e rOD,�O cJoL.jr), tvis-V N Peel Aral _1"CIC
L 2/ r'CdY�I, rn 4-IQ!/ d 6aAS0l ;7 R-�e_ v err_
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
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: 3) C7
_ Shutters _ Windows/Doors _ Pond
Generator ✓Roof 3 /l Z Pitch
Sq. Ft. of First Floor:
Cost of Construction: $ Z2rt OO Q. O C Utilities: _ Sewer _ Septic Building Height: 1 Z i
OWNER/LESSEE:
CONTRACTOR:
Name EVCI --Fl. l l; d1D./i Z
Name: -Dulce 4-1'ya
Address: SSI nx55-i3 7r
Company:IV-S `q1te ReA-cA
w-oof EXa&}s//
City: -*� Lo✓ l �,'wGe State: FL
Zip Code: -3q Fax: %1//
Phone No. / 1A E-
Address: 3140 6E IA)6141d"
S%
City: G4W_L1-� State: P�L
Zip Code: 3ygA_� Fax:
Phone No •4- Z — — 503a
Mail: AIZZ
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail ardAf;4S tiseine,4o*po
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State or County License f Gr i 33?,§
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If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
FSUPPLEMENTALCONSCRUCTION LiEN LAW iNFORAAAT10Nr
COMPANY: _Not Applicable
Address:
City:
Zip. -
FEE SIMPLE TITLEHOLDER. _ Not App%ONDING COMPANY: _Not Applicable
Name: Name:
Address: Address
City: City:
Zip: Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installatlon has commenced prior to the issuance of a permit.
St. Lurie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which wnflictswithanyappficableHomeownersAssoda'anrules, bylaws ora dwvenamsthatmayrestrictorprohibitsuch
structure. Please consult with your Homeowners Assocation and review your �eed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. ' , ' !"
The following building permit applications are exempt from undergoing a full conwrrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to cord a Notice of Commencement may result in paying twice for
Improvements to your prop . A Notice of Commencement must be recorded in the public records of St.
Lucie County and post a jobsite before the first inspection. If you intend to obtain financing, consult
with [ender$r a efore commencing work or recording vour Notice of Commencement.
S eofContractor-or-ownerBuilderasapplicable
STATE OF
4-�Enz-h
COUNTY FORIDAP14M
Swam to (or affirmed) and subscribed before me of
�hysical Presence or _ online Notarization
this jjE day of 1) = C.. 202f by
bul.r<E 1-4t2R-
Name of person making statement.
Personally Known OR Produced Identification
Me dentification P aced
(Si atureof Notiry Pubffc- atof Flo ' a)
�"
mmissivn No. �� 7 /1 o% (Seal) {
Na,�ry AOblic St
ate of Flondse
"a!a;; Fv pia!;na
_ - i •: Tn`.Uon 3G 21-1052
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED