HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COL? -__TED FOR APPLICATION TO BE ACCEPT& —
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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
PERMIT APPLICATION FOR:
PROPOSED,IMPROVEMENT LOCATION
Address: 7960 Plantation Lakes Drive Port St Lucie, FI
Property Tax ID #: 3321-803-0012-000-7
Site Plan Name: Reserve Plantation Phase II -A
Project Name: Jason A Moore and Karen L. Vassell
Lot No. 6
Block No.
:DETAILED DESCR;IPTIOWOF-WORK A `>
New Residential Construction
New Electrical Meter ` e!: 5 Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
`Mechanical Gas Tank —Gas Piping _ Shutters _(,--Vllindows/Doors _ Pond
Electric Plumbing Sprinklers 'Generator Roof Pitch
Total Sq. Ft of Construction: �� J%3 Sq. Ft. of First Floor: 3 6
Cost of Construction: $ % ® Z_ Utilities: _ Sewer Septic Building Height:
OWNER/LESSE
CONTRACTOR:
Name 0l��
Name:
Address: 0
Company:
City: S L State: jE&
Address c,! Y u/rr1 7M
Zip Code: Fax:
City: .S�uAtcq— State:
Phone No.
Zip Code: .3`fIj f> Fax: -777- -cf Y(e i
E-Mail:
Phone No 7/1 L_— iq— �17f_
E-Mail CAIU i- Cd !'1111wtl: 5- 4Y _ ugg-i ► `.1
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License_ CGC lrX 0 7(
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: l Name:
Address:. I Address:
City: _ State: ! City:
Zip: Phone _ I Zip: Phone:,
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Lip: ___- Phone:_
— Not Applicable I BONDING COMPANY:
Name:_
Address:
City:_
Zip: _
Phone:. _
__State:
Not Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated
I c=rfify that no work or installation has commenced prior to the issuance of a permit.
St. Luc a County makes no representation that is granting a permit will authorize the ps'rmit holder to build the subject structure
which :s in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult vnlh your Homc Owners Association and review your deed for any restrictions which may apply.
In rnnsideratron of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the vrork
in accordance with the approved pans, the Florida Ouildinp Codes and St. Lucie County Arnendritents.
The following buildikD permit applications are exempt from undergoing a full concurrency review: room additions,
accessary structures, swimming poors, 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 recofding your Notice ofkvmmenceiiient.
ractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF�%i4`a �4fv�
Sworn to (or affirmed) and subscribed before nee of
Phy;iral Prme=e or _ Onl:ne Notarization
this /.,. day
of / b rGtA,-2.v , 2021 by
I+ . ))0v d_A__
Name of person making statement.
Personally Knovm t-� oR Produced Identification
Type of Identification
Produc / 6
11.
i , 2, ' MY COMMISSION #
C GG 229Y16
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REVIEWS i FRONT ZONING
COUNTER REVIEW
DATE
I RLCEIVED
DATE
CO.'APLETEO
rTeu._S/6/20
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OFAr-
�in
Sworn to (or affirmed) and subscribed before me of
__X,Physicai Presence or Online Notarization
this \,;), day of A{ 202N by
t
Name of person making, statement.
Personally Known _ OR Produced Identification
Type of Identification
Produced
(Si EfC
teoNotary Pu is State of F:orida )
a4s:A;'u*, LE AMARIEMCKINNEYISealj
Commissj�o� Cemrriloalnp#pG231947
'Me Explres June 25, 2022
SUPERVISOR PLANS VEGETATION
REVIEW i REVIEW REVIEW
SEA TURTLE MANGROVE
REVIEW REVIEW!
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