HomeMy WebLinkAbout423 NE Willows Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
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° Building Permit Application
Planning and Development Services /
Building and Code Regulation Division Commercial Residentialy
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: _ 47•3 NF- WILLOWS A`!C poA-7, S-r. LuGit= /FL 34q
Property Tax ID #: Lot No. Z
Site Plan Name: Block No. I (0
Project Name:
DETAILED DESCRIPTION OF WORK:
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ADhFlt.ntG UJ40JFi2CkYYA)EIV'I^STALL N15L- ASphAi-7 SH114&Prf
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 vRoof 3//Z, Pitch
Total Sq. Ft of Construction: 2.10 S O Sq. Ft. of First Floor:
Cost of Construction: $ / 21 'ro 0 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name.ir.pti e-L,6$E Jwy 13RtNISILt=7
Name: MICMAaL M\L-LL=1Z
Address: 233 W t es1%ACn1tt bt-
Company:T PAbE w 1.WbS IZac>F-imti /AV
City: 571uAo9 State: l_L-
Address: RD 06-s tSz.& t
City: Fa PII I?Cr; StateJt-.
Zip Code: 3 Ao 4 4 4- Fax:
PhoneNo.'t'12^ 33S^ 14'1 S E-
ZipCode:34Y7'I Fax:
Mail:
Phone No 772- A1*40- g47-0
Fill in fee simple Title Holder on next page (if different
E-Mail rntK� [+ T2Jrbr' ,14)`/YO5 I�m
State or County License C C CO 573 t%. '
from the Owner listed above)
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.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
Gty: State: City:
ZIP: Phone State:
ZIP: Phone:
FEE SIMPLE TITLEHOLDER: _ Not.Applicable BONDING COMPANY:
Name: _Not Applicable
Address: Name:
Address:
City:
ZIP City: Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certdv 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 witha co any applicable Homeowners Association rules, bylaws or and covenants that may restrict
structure. Please consult
or prohibit such
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, fehces, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice Commencement
of may result in paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records St.
of
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with le der or an attorney befte
Commencing work or recording our Notice of Commencement.
signatUreofContractor-or-OwnerBuilderasapplicable
STATE OF FLORIDA
COUNTY OF L C r
Swotq�p,ffor affir ed) and su scribed before me of Physical Presence or Online Notarization
thiszNayof r�
tr 201-f by
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Name of person making statgmEnt.
ally Known ✓ OR Produced Identification
ldeMificoduced
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(Signature of Notary Public- Sta Florida)
1/,/ vn'•, FELICIALYNEWILKIN
Commission No.7"(T, /JJ55 i (Seal) € `; Notary Public - state of Florida
n j+" Commission r HH 160538
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.,an;.� My Comm. Expires Sep a, 2025
Banded through National Notary Assn.
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ev 10/12/21