HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
DateJjaj Permit Number:
S- L-LLLL
Building Permit Application
Planning and Development services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial
CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 8575 Gallberry Circle Port St.Lucie 34952
Property Tax ID #:
Site Plan Name:
Project Name: Giasullo-8575
3425-703-0130-000-2
DETAILED DESCRIPTION OF WORK:
Install new 4-ton 14 seer 10KW Weather King Package unit
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Residential X
(Affidavit required)
Additional work to be performed under this permit —check all that apply:
XMechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction:
Cost of Construction: $ 5480.00
Lot No. 7
Block No. 24
Windows/Doors _ Pond
Roof Pitch
Sq. Ft. of First Floor: _
Utilities: —Sewer —Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Salvatore Giasullo
Name: Luke Walker
Address: 8575 Gallberry Circle
Company: TREASURE COAST AIR
City; Palm City State: _
Zip Code: 34952 Fax:
Phone No. 772-877-3621 E-
Address: 1055 S.W. MARTIN DOWNS BLVD
City: Palm City State:
Zip Code: 34990 Fax:
Phone No 772 692 1701
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail TCAC1990@ATT.NET
State or County License CAC058476
it value or consirucuon is LSUU or more, a KtcoKDED 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:
_
Name:
Address:
Address:
City: State:
City: State:
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 conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners Association deed
and review your 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.
l
Signature of ntractor - or - Owner Builder as applicable
STATE OF FLORID
COUNTY OF_Mck +io�
Sworn to (or affirme nd subscribed bef me of Physical Presence or Online Notarization
this J-3— day of C` f1 20y
Name of person making statement.
Personally Known �X OR Produced Identification
Type of Identification Produced
r no
(Signature o Nota ubli State of Florida) -
N
No. (Seal) NICALYNE"
�
F1SOWCommission
128MCOMMISSION 9
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REVIEWS
FRONT
COUNTER
ZONING SUPERVISOR
REVIEW REVIEW
PLANS
VEGETATION SEA TURTLE
MANGROVE
DATE
REVIEW
REVIEW REVIEW
REVIEW
RECEIVED
DATE
COMPLETED
Rev