HomeMy WebLinkAbout3-106.pdfAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2 - 7 aZ,?-
Hermit Number:
9t
c I c 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) 462-1S78 CBDG Funding
PERMIT APPLICATION FOR: !01GfM6��t
PROPOSED IMPROVEMENT LOCATIO :
�3 L� e V '=Address:
_
_ , s14l0„ Por� Sf tUci _3 y95oz
Property Tax I D #: .3 ZZ'.�d ' 603 Ci44 7
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Ce ,3 J cfallo17 e 1 ec *—,'e
Lille_ -For Like,
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
—Electric /Plumbing —Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $
OWNERAESSEE:
Name onan VLen Horn
Address-, -3 Lake V 1 S at —rra i % m 10
Generator
5q. Ft. of First Floor:
Lot No.
Block No.
Windows/Doors Pond
Roof Pitch
Utilities: _ Sewer — Septic
city: _Ebr� 54 Lu eti e state: &
Zip Code: Jq 9507 Fax:
Phone No.—,96a g Sl , a 788 _ E-
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
Building Height:
Name: L2gry vy 4anelto
Company: 'Port _ if L-�Gf e U
Address: a en ( r f
City: tb t LLLCie State: fG
Zip Code: 3 ii Fax:
Phone No 77d Y68-65a q
E-Mail I`f L ie LIM t l •CDC,State orCountyLicense CK, g4a4m
$ D r7
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 CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
nwluFR/ rnlulroarrnQ Accin.nr.
— - - • —• �ff% � § + Mo v j 1, f+fJN1P4dL1Uh is hereby made to outain 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 or an attorne before commencing work or recording our Notice of Commencement.
Signat r f er/ Les a/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF S L VC) e,
Swornto (or affirmed) and subscribed before me of Physical Presence or online Notarization
this ; ,r,,day of_ �Ph .,�, ZO^ by
Narne of Irson making statement.
Personally Known / OR Produced Identification
Type of Identification Produced
of Notary Pwlic- State of Florida)
Commission No. 603 6 09 (seal)
REVIEWS I FRONT ZONING
COUNTER I REVIEW
TE
DATE
COMPLETED
Comm.01313381658
BMW Tivu Am Nobly
SUPERVISOR PLANS I VEGETATION I SEA TURTLE I MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW