HomeMy WebLinkAboutBuilding Permit Application-VandelloAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /& ✓>I (31 Permit Number:
S-)`�o L-u cLL
o J.A.
° l� Building Permit Application
Planning and Develog ment Services /
Building and Code Re 7ulationDivision Commercial Residential
2300 Virginia Avenue Fort Pierce FL 34982
Phone: (772) 462-1 i53 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: p �
orl o-SP S lr a des. do.. ec
PROPOSED IM ROVEMENT LOCATION: 7
Arlrlracr 1nct"7 GI 1. IAA.._-f I.1 ....
Property Tax ID #:
Cq "
01- oV77
•0c l iz -� I
Lot No. 14
Site Plan Name: 10
?q
W0 l .ad`
Block No. N4
Project Name: 54k
re,S&,i
e arf-�
DETAILED DES
IPTION OF WORK:
It�M-aJy t
e K% k-
.- e. rh c,' l Mo.E1 o v e., Pear cTiv�-� i=c l c
nee.1 �►- �ie.P1
ck he-w rne.�_
t
IJ
QAS Icsw
O_L vxr C►11-4
%,- avi-.li-
New Electrical Meter
Second Electrical Meter (Affidavit required)
CONSTRIL
INFORMATION:
Additional work to bc performed under this permit - check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
Electric Plumbing _Sprinklers _Generator
Windows/DoJors z/_ Pond
✓roof l/1'?- 7/ -Pitch
Total Sq. Ft of Constr ction: , Sq. Ft. of First Floor:
Cost of Construction: $ 7.17 gZ Utilities: _ Sewer _ Septic Building Height: i C
OWNER/LESSEE:
CONTRACTOR:
Name Cf
0.
Name: 15'J(ee ✓c*--
Address: 104 "K%- kitMA"Lds fit./
C��mmpp��r]y �}al SyS6Cr.Ttit Mew./
City: �6N.SGs') .�� State: FL
Zip Code:34f37 Fax:
Phone No. d Cyo E-
(covre 4
Addrecssy:� 3/`/o SC Ir.s qa"/t✓ t
City: 5L-u .�✓I- State:
Zip Code: �rf q -1 Fax: 't�1 9i3 S(i173
Phone No ? x R7 >- W3 O
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail i e✓n its ec> i{e e.e,61 N<i
State or County License_ CCC / 33 a"
It 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.
SUPPLEMENTA
CONSTRUCTION LIEN LAW INFORMATIO
DESIGNER/ENGIN
Name:
ER: Not Applicable
AGE COMPANY: _ Not Applicable
NM
Na
Address:
City:
Zip:
Ad ress:
St t
hone
Ci
p:
State:
Phone:
FEE SIMPLE TITLE
OLDER: N t App c I
BOND G CO PANY: Applicable
Name:
_Not
Nam
Address:
Addr ss:
City:
City:
hone:
Zip: Phone:
Zip:
OWNER/ CONTRAC
I certify that no work or
rOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
Installation has commenced prior to the issuance of a permit.
St. Lucie County makes 1
which conflicts with an
structure. Please consu j
o representation that is Granting a permit will authorize the permit holder to build the subject structure
applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
with your Homeowners Association and review your deed for any restrictions which may apply.
In consideration of the 1
in accordance with the ipproved
ranting of this requested permit, I do hereby agree that 1 will, in all respects, perform the work
plans, the Florida Building Codes and St. Lucie County Amendments.
The following building p
rmit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, sA
mming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWN
improvements to
Lucie County an
with len
R: Your failure to Record a Notice of Commencement may result in paying twice for
your prppefty. A Notice of Commencement must be recorded in the public records of St.
pos on the jobsite before the first inspection. If you intend to obtain financing, consult
efore commencing work or recording our Notice of Commencement.
- or - OwnerBuilderasapplicable
Signat cto
STATE OF FLORID
COUNTY OF
M
Sworn tq (or affirmed)
this day of
nd subscribed before me of Physical Presence or _Online Notarization
20 Y_ by
Name of person makin
statement.
Personally Known
OR Produced Identification
Type of Zanon E
7Vy-
(Signature of Notary P
"Iof F rida)
I
Commission No.
THERESAJAFFE
�a•3cI (Seal) Notary Public Stale ofFbrlas
Commission # GG 202301
My Comm. Expires Apr 1, 20.
oed through National Notary Assn.
E
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COUNTER
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REVIEW
SUPERVISOR
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REVIEW
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RECEIVED
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COMPLETED
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