HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1
Date: 14 3 1 I 1-1 Permit Number:
Lk,,, irCLL ..,
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fart Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial
CBDG Funding
PERMIT APPLICATION FOR: it VAC
PROPOSED IMPROVEMENT LOCATION;
Address: Crab . PEL I FL S(t
Property Tax ID #: 33 - 76GI - lo - 4
Site Plan Name: p02.-(. AtTVie- c Ph r 'Z
Project Name: �NAC - N't f-ct� 1 n ill Cn I I r C ktq
DETAILED DESCRIPTION OF WORK:
YYI (0 E.E
w eager I I kP P
Residential
AIC
New Electrical Meter Second Electrical Meter
(Affidavit required)
CONSTRUCTION INFORMATION:
X
owt
Lot No.—g] ,—
Block No.
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: Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: y Sewer ^ Septic Building Height:
OWNERAESSEE _
CONTRACTOR:
Name eon I S
e rs
' Name:
Address: 10 2 r
[ f QS COmny: m
City: r I . w C{ State. Address: u N IN
Zip Code: Fax: City: PRO a CI
Phone No. 570 Z j � 37Qz �-�. State: �
E- Zip Code: Fax: /�
Mail: I" aX15 O Y� CLO CC hone No 77 Z 3Ll Q14- 0
Fill in fee simple Title Holder on next page (if different E-Mail c l rA ') t Q . tom
from the Owner listed above) State or County License_ y%3
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.
SUPPLEMNTAI CONSTRUCTIQN
L(N LAW
IN�ORMATInN
DESIGNER/ENGINEER. _Not
Applicable
,.
MORTGAGE COMPANY. Nat A licable
Name:
Name:
Address:
Address:
City:
Zip: phone
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ rnIUTRAr~•TnR ecrtnvrr..__.:
- - -- - •• -- • --•- �• • 1M Y I Y • MNNiiLd L1Un is nereoy mace to ootaln 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 au applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consu t 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 our Notice of Commencement.
Signature of Owner/ Lessee Contractor as Agent for Owner
STATE OF FLORIDA COUNTY OF _ 4 1 C I
Sworn to (or affir ed) a d su scribed before me of
this -a day of zOZ 1 by
Physical Presence or Online Notarization
c i}'}' ,
C.eri cjCi MO
Name of person making statement.
Personally Known Y- OR Produced Identification
Type lentification Produced_
(Signature of Notary
11[
P��ubli/c-St/a�te of Florida)
Commission No. '•'1 Loneal)
REVIEWS I FRONT
COUNTER
DATE
RECEIVED
DATE
COMPLETED
ZONING
REVIEW
Notary Public State of Florida
Brianna V Lorenz
• MY Commission HH 042089
z.pir®s 09/14/2024
SUPERVISOR PLANS VEGETATION SEA TURTLE
REVIEW REVIEW REVIEW REVIEW
MANGROVE
REVIEW