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HomeMy WebLinkAbout6106 Tangelo TerAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: LUTC_flL 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 LOCAT[ION: Address: 1)2 , Property Tax ID #: �"r 7�! © Lot No. Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION OF WORK: 11/10 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 _ Windows/Doors _ Pond — Electric — Plumbing — Sprinklers — Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ k4 Utilities: —Sewer Septic tsi ,.ling Height: OWNER/LESSEE: CONTRACTOR: Name Name: Add ire s: M Company: f i Address: City: State: Zip Code Fax: City: State: Phone No. .. E- Zip Code Fax: Mail: Phone No Fill in fee simple Title Holder on next page (if different E-Mail lm from the Owner listed above) State or County License 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 Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone Address: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: , Not Applicable Name: BONDING COMPANY: Not Applicable Name: Address: City: Address: 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 attornev before commencinLy work or recording our Notice of Commencement. 22 If A I di, I ZfPbd4Z_W__ %'4kk a.%, Sig ure Owner Con actor as Agent for Owner STATE OF FLORIDA COUNTY OF ,/-L I Y- Swor to (or affir ed nd subscribed before me of sical Presence oy Online Notarization this day of 20y Name of pers king statement. nalEKno' OR Produced Identification n Produced t ox 1 k (Signature of Notary Publi ate of Florida) LIBERTYA KING , Commission No: (Seal) '�,� MY COMMISSION#HH120374 r ��= EXPIRES: May 4, 2025 Fci fig ` BOntSei3 itw13 Notary POW Underwrmn REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Kev 5/76/11 ST LUCIE COUNTY F L 0 It 1 0 A t M114121 WATER —COMM SfWER RE mt. it R sz, wf !RR Rectwdmg Fee Met" Install Lateral Servkv us-ve cFcjw&tet CFC/S#wer FPUA CfC Guar. Rm TOTAL DUE ST LUCIE COUNTY WA7 NEW CUSTOME N"Af )(--,ckktc ACCT- X SERVICE �4 SUBDIVISION LOT_.0— Sim FKMt AOMESS: jar 4 q 61 C PHONE: This apWicaltofl hereby requests 40d 4uthoWtl� tht Ut 14Y to render w4tef Andjor -ewW d*po-1 servkes to the prmws dewribed Almvp in �Kxofdilnft- , with the Utihties pfesent or fluttar €aces, rules and regulations, Much by reference are M&&. a pan of this con"m Apok-ant agrees to pay UIdttv womptly for such scrWel n accorcance %wth the estabLthtd rules and iegulaVrons. CUSTG,MERS DEPOSITS ARE NON NEGOTIABLE OR TRAWCRAKC, APPI,f('A**T At TRAT APPLICANT WILL BVGtN,' PAYING RASf. VA01,11-Y C11ARGFS FOR THE 17,11111"'4YRMF APPMM FOR ON TIM DAY TMf WATFA MFTFP. OR OMFR I-MM SFRVI('F (I)NNI(MON, IS INSIX11,YD AT APPLICANrS PROPERTY, RFGARI)1,F.";iOF WIWNAPPLICAN-f STARTIS I NOW CUSTOMER SIGNATUff SPOUSE SOCIAL NAME OF SPOUSE ------ OFFICE USE ONLY CAS14 RECEIVED By ? ��