HomeMy WebLinkAboutSLC Permit App - Ramon CabreraAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Xil uu,,.jL y
Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982 Residential
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
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PROPOSE IMPROVEMENT LOCATION:
Address: 71;rr9� S,cLi /Deuc
Property Tax ID #: 3<✓��� �S®�
Lot No.
Site Plan Namei C�ri_cPLn
Project Name: i,_t_r;7, -LL P t✓ L Block No. ZG
DETAILED DESCRIPTION OF WORK:
aseru(_ Ls %!t i n `.A
New Electrical
CONSTRU
/b -!' �L .i=. Or!= G r� r� �1 L i :t f vva �Y �'l.�vtC-` c✓c ;�� rira-�
r Second Electrical Meter
ON INFORMATION:
Additional workto be performed under this permit —check all that apply:
Mechanical _ Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing Sprinklers — Generator
Total Sq. Ft of Construction:
Cost of Construction: $ f,, rt qp,u,�
OWNERAEStEE:
(Affidavit required)
— Windows/Doors Pond
Sq. Ft. of First Floor:
Utilities: — Sewer — Septic
Name P,.gmo,+ C.+aRef1j*
Address: ,Gs Z I-tM� S;r,zz-r
City: ' u,,r- S,�-LLB-CLI State: r`k_
Zip Code: _ r.S2 Fax.
Phone No. 2Q I Z9C 7hr9'2. E-
Ma i l: fr2 e; G L,-Amj v�EM 0 yt; . La, du
Fill in fee simpleTitle Holder on next page (if different
from the Owner listed above)
Roof — Pitch
Building Height:
CONTRACTOR:
Name:
Company:
Address: 7s1,[c4J [-,iL-tifol.c.�
City: PL-C-[ ST L-u c c j�Z State: X-
Zip Code: .L2'9436 Fax: 77Z yoo eL72
Phone No '772- ALL 021.3
E-Mail j.,jr=n p is c"
State or County License
If value of construr tion 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: _X_ Not Applicable
Name:
Address:
City:
Zip: Phon
State:
FEE SIMPLE TITLE HOLDER: , Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name., _
Address:
City:
Zip:__-_
Phone:
Not Applicable
State:
_Not Applicable
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 TOI OWNER: Your failure to Record a Notice of Commencement may result in paying twice for
improvements to yo,V property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and p. ted 0 the jobsite before the first inspection. If you intend to obtain financing, consult
With lanria.r nr an tnrrragv hQfnrp rnrnmencine work or recordiniz vour Notice of Commencement.
Signature of Co` t or or - caner Builder as pplicable
STATE QF F , RIDA
COUNTY O I
Sworn to for affirmed) and subscribed before me of
X_ Physical Presence or Online Notarization
this 2-4 day of �,.���ttc�t 202.a..by
/��
N itl-tl C re_]
Name of person making statement.
Personally Known OR Produced Identification
Type � eW0tinced
(Sign ure N tary Publi - Stat orida)
Commission No. 52eal) ,W
Notary Public&tAte of Fonda
Crystai E Naylon
My Commissian GG 929549
.6
Expires 1110612023
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 10/12/21