HomeMy WebLinkAboutBUILDING PERMIT APPLICATION - 2904 GROVE DRIVE - 12-27-2021All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
LL!CLL -
LLL!lt
c L o I.', c 0 tti 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: 2-9&A C.roye- r►je, foy-t Pierce, FL 349,91
Property Tax ID 10-0W 1 4- 000— 0
Site Plan Name: ,,�� ��}}..
Project Name: AG Clr��ncie W1�
X
Lot No. Al
Block No.
DETAILED DESCRIPTION OF WORK:
PYnnr TIP P V ► nr1 ails �. I,f ;-�n►[Yi Sy`?"Pm y forts n 'tmi-al l
it►� f1 i
10 KW eec lcl heater. " -
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
Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction:
Cost of Construction: $ 5,S1Q)
Windows/Doors _ Pond
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name rR. 1
`
Name: •
INC.
Address: ejjt6Company:
City: Fba P te, -M State: EL
Zip Code: 3��1. Fax:�/
Phone No. �� '2ks— PICK) E-
Address: l(134 SN '�AiD,�,,"OM SV�
City: Port Sant Wde State: f
Zip Code: 314RK4 Fax:
Phone No50c)5
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
�1
E-MaillnC�OQICp.;trCQJI'e �SI� q►I• �rri
State or County License GAC,1$1G'J0G3
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:
Name:
_X Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
Address:
_
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY:
Name:
X Not Applicable
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 your Notice of Commencement.
.1 1A
Signature of Owner/ Less r gent for Owner
STATE OF FLORIDA
I
COUNTY OF .scani i_ e-
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this ] day of LStff �, 20 );tby
Name of person making statement.
Personally Known_ OR Produced Identification
TypAof n ification Produced
(Sig ure of No ry Public- State of Florida)
,, LYMARI REYES
Commission No.4�l� �,"> (Seal) =`'HYPO°,Notary Public -State of Florida
Commission M HH 185477
My Commission Expires
October 12, 2025
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Rev 5/20/21