HomeMy WebLinkAboutCaprona Permit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
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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:
Address: III Nt CaDrpng Gd-C
Property Tax ID #: 3tA 9 -5- 023 000 -0 Lot No.
Site Plan Name: Block No.
Project Name:' `�
New Electrical Meter Second Electrical Meter
(Affidavit required)
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: _ Sq. Ft. of First Floor:
Cost of Construction: $
Windows/Doors + Pond
Roof Pitch
Utilities: __Sewer _Septic Building Height:
Address: III Nt CaDrpng Gd-C
Property Tax ID #: 3tA 9 -5- 023 000 -0 Lot No.
Site Plan Name: Block No.
Project Name:' `�
New Electrical Meter Second Electrical Meter
(Affidavit required)
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: _ Sq. Ft. of First Floor:
Cost of Construction: $
Windows/Doors + Pond
Roof Pitch
Utilities: __Sewer _Septic Building Height:
F
Name rci 12 (01,10 ko
IcutIAs UIU
Name:Jo�i ]_ Ike-
Address:3zd U) Qhl'Q
Company:�uf
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Elcr^,ty'
City: �{ j_C State: ��
Address: �IZIi I S(d) I11�(]�g&Ng CIY' _
Zip Code: (p Fax:
D
City: folm cibi State:
Phone No.
Zip Code: -,3--qqq Fax: JJZ z 9-32-2
Phone No 1Z- ZI9-33M _
E-Mail. br r {r- cIrG1 ri C. [nm
E-Mail:_
Fill in fee simple Title Holder on next page ( if different
State or ounty License E Ov3y
from the Owner listed above)
a value or construction is [DUU or more, a KtwRutu Notice ar commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
l`lPPLEMEI�ITAL CONSTFtl TIN 11EN LAW INFQRMATIONi ` # `
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: _ Address__
_
City: State: _ City: State: A
Zip: _ Phone _ Zip: _ Phone:_
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
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 is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and reviewyour 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 commend g work or recording your Notice of Commencement.
Signature f Owne>Lessee ontractor Agent for Owner
STATE OF FLORIDA
COUNTY OF _Matkn
Sworn to or affirm d) ind subscribed before me of yPhysical Presence or Online Notarization
this ayof_ 20ZJ by
Name of person making statement.
J Oy Kr r C VV ,, JESSICAR. BRYAN
Personally Known OR Produced Identification_� 'i�'t MY COMMISSION # GG 20369
Type ofldentificati Pr uced_ ExPIREs;Odnber19,2022
-ABonded Thru NOIery Public Undembr,
(Signature of Notary Public- State of Florida j
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 5/20/21