HomeMy WebLinkAboutSLC Permit App - Andy FerreraAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: r-LnnLJj4JcY L �.�z 2Permit Number:
O� U�
9 n 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: :
PROPOSER IMPROVEMENT LOCATION:
Address:
Property Tax ID #: -?'Y/S 76L e,��' y r� �,
Lot No.
Site Plan Name:
Block No. !
Project Name: lni� ALL j",VC
DETAILED QESCRIPTION OF WORK;
J
7� 4L 7-t L./=
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit - check all that apply:
.,,,_Mechanical _ Gas Tank — Gas Piping — Shutters
_ Electric _ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ Z , %-L 3,,-) , cro
Sprinklers Generator
(Affidavit required)
Windows/boors Pond
Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _ Septic
OWNER/LESSEE:
Name Ames g-ixi
Address: G7 7 s Y �>piis�i�tl %�tre�
City: PDPLt--- St Lvc.Laf: State: !-L
Zip Code: 34 i.SZ Fax:
Phone No. 7e(, 4Vq Zz.� U E_
Mail: .4 m6 t'z.a'ri)
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
Building Height:
Name: n;+&t, te.rc
Company: A 6,eL yi-7-
��✓
Address. '7-ir/ AJLJ t ic-I�►�rud�` (�cL_
City: t��<+ S;� �ca�cL State: 1=1-
Zip Code: J YPYL Fax: 772 q0,9 OZ7Z
Phone No 772- 8tz oZz3
E-Mail jAir e) 6- G,crn�Tr�z
State or County License C-GC i.!�-z7-T7i
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 CO
DESIGNER/ENGINEER:
Name: _
Address:
City:
Zip:
NSTRUCTION LIEN LAW INFORMATION:
Not Applicable
Phone state:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
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 yo r property. A Notice of Commencement must be recorded in the public records of St.
Lucie County a d p sted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender o an; ttor b0pre c mencin work or recording our Notice of Commencement.
Signature
STATE FI
COUNTY OF
-or-
-r LUCL .0
r as applicable
Sworn to (or affirmed) and subscribed before me of
this i day of t- f3iie t: I2Y 20�7__ by L1 kira r r
Name of person making statement.
Personally Known OR Produced
Type^dentification Produced
tlgnature,Jbtary Public- State of Florida)
r� �/� C
Commission No &C- aZ5!54 (Seal)
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Physical Presence or
Jg Notary PubbC Stete of FYorida
Crystal E Naylon
i Wfy Commissipn GG 829549
p Expires 1110612023
SUPERVISOR PLANS VEGETATION
REVIEW REVIEW REVIEW
Online Notarization
SEA TURTLE I MANGROVE
REVIEW REVIEW