HomeMy WebLinkAboutLawerence Ieropoli Permit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
I LIT U
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 CBDG Funding
PERMIT APPLICATION FOR: A ccor-d no
PROPOSED IMPROVEMENT LOCATION: JV ► �C
Address: Z(0-1 n 'orb C (r �\
Property Tax ID #: ����I " �(� (- 0 16by
Site Plan Name: e
Project Name: LO I rce C-e -1:-e- C)tom- 0 � 1
DETAILED DESCRIPTION OF WORK:
inSL!21 IC-H()n D51 Touorclw sbU-1ie.,LS
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
Lot No. Zo
Block No.
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank _ Gas Piping ZShutters _ Windows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ I � 1 0 (0 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameLOU)eVenD
Name: FY00V I ':;�_Q; _O
Address: qo(j '5h(ri" C li�2 Cjr
Company: , IL)
City: �k)t lu ct Coo f l-u l ' State: FL
Zip Code: �P CI G Fax:
Phone No. `�_ 011 " io E-
Address: nl 5_NLVV en+ev--pv]S e C�
City: V-t S } G t State: r-L
Zip Code: 3 , (fl Fax:
Phone No 112
E-Mail U S{ V f� % I C60?
Mail: E�Vyl@, CbTJCC(S+ne-4
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License LI 9
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 CONSTRUCT ON LIEN LAW INFORMATION:
DESIGNER/ENGINEER: I
Not Applicable MORTGAGE COMPANY: of Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone: n
FEE SIMPLE TITLE HOLDER: / Not Applicable
Name: /
Address:
City:
Zip: Phone:
BONDING COMPANY
Name:
Address:
City:
Zip: Phone:
—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 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 an attornev before commencina-we& or -recording vour Notice of Commencement.
ignature of Owner/ Lessee/Contractor s A nt for Owner
STATE OF FLORID
COUNTY OF l U C,7e
Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization
this .aa day of �P.' V-"\ 20aa-by
rA % G`-
Name of person making statement.
Person OR Produced Identification
Typ of Identifica io Produced
A
—
(Signature o Notary Public- State of Florida)
Commission No.AG cc, Sea[) 1111,9, ALYSSA A.T. BOWSER
*� * Commission # GG 295930
Expires January 28, 2023
Bonded Thru Budget Notary Services
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Kev 5/Lu/z1