HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE �p SST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: U�/ v�
Permit Number:
171
F L
L �1
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Commercial Residential
CBDG Funding
I PROPOSED IMPROVEMENT LOCATION:
Address: 620 RUSS RD FT PIERCE FL 34982
Property Tax ID #: 3410-603-0009-000-2
Site Plan Name:
Project Name: LSCI INCE
DETAILED DESCRIPTION OF 1NORK
New Electrical Meter_ Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping Shutters
Electric Plumbing _Sprinklers
Generator
Total Sq. Ft of Construction:
Cost of Construction: $
Lot No. 10,11,12,13
Block No.
(Affidavit required)
Windows/Doors Pond
^— Roof ----______ Pitch
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic
I OWNERAESSEE
Name JOHN MUGGLI
Address: 620 RUSS RD
City: FORT PIERCE
Zip Code: 34982 --
Fax: State: FL
Phone No. 1 (561) 317-0926
Mail: MUGGL110@HOTMAIL.COM
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Building Height:
CONTRACTOR: —
Name: RAYMOND MEAD --
Company: LSCI INC
Address: 7300 BRYAN DAIRY RD SUITE 400
City: SEMINOLE FL
33777 State:
E- Zip Code: Fax:
Phone No 7�75714—
E-Mail permits@suntecsolarenergy.com
State or County License CVC056656
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: MINDY NICOLE ONEAL
Name:
Address: 5700 LAKEWORTH RD
Address:
City: GREtNAGEState: FL
City: State:
j Zip: 33463 Phone 561-317-0926
_
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
�I
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 1 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 your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
I
STATE OF FLORIDA
COUNTY OF PINELLAS
I
I
Swornjo (or affirrr�e gubscribed before me of ''Y'r Physical Presence or Online Notarization
this day of 20 21 by
Name of person making statement.
Personally Known V` OR Produced Identification
Type of Identification Produced
(Signature of Notary Pu - ate of Florida)
�.00 Notary Public State of Flonda
Thang Phu
Commission No. (Seal) . My Commission GG 975932
Expires04/05/2024 !
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