HomeMy WebLinkAboutDionisio Brache.pdfAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
L `' 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:
PROPOSED IMPROVEMENT LOCATION:
Address: A_Jk �f . 4i14 A, ; I,
Property Tax ID
Site Plan Name:
Project Name: � ftoy ,
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
Mechanicals Tank _ Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction:
Cost of Construction: $
(Affidavit required)
Sq. Ft. of First Floor:
Lot No.
Block No.
Windows/Doors _ Pond
Roof Pitch
Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
P
Name i
Name:
Address:, K
Company:
City: - State:
Zip Code: `t Fax:
Phone No. E-
Address: ' j .
City.
Zip Code: R
Phone No
State:
Fax:
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail
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State or County License ; t ., 70
. a..-- — w ..a a. Mua. v 11 1. L.JVV U1 111U1 C, 0 RC%.VRUCU IYUiIGe 01 commencement is requlrea.
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:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
Address:
City: State,
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
Address:
City:
Zip: Phone:
V vvIV CK/ LUlv I KAL I UK Aht1UV11: 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 and applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consu t 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 attornev before commPnrinu Wnrk nr rarnrAna "„limo nl„+,, „F r,,,, ��
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Si *ef 4Lsst o
STATE OF FLORIDA,
COUNTY OFF,
Sworn to (or affir ) nd subscribed before me of
this day
Physical Prese or Online Notarization
of 20y
Name of person making statement.
Perso Ily Kn n OR Produced Identification
ntificat"on Produced
gna ure of Notary Publ c tate of F orida)
Commission No. lr)� '(Seal) :.''�
LIBERTYA. KING
MY COMMISSION # HH 120374
p; :-
EXPIRES: May 4, 2025
'-,tj f �?P:
Sondod Thru Notary Pu* IM�
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev5120/21