HomeMy WebLinkAboutSinotte, Kim permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2,17 / 1,2 Permit Number:
cz c Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: L>^ C ra cC-
PROPOSED IMPROVEMENT LOCATION:
Address: 7 SUS R.0 F}O
Property Tax ID #: / 301 - (vol - Oasy - 0o) - Lot No. 10
Site Plan Name: SI Jo Til'r Block No. 13
Project Name: Si NO fie -
DETAILED DESCRIPTION OF WORK:
R64L4CF_ (.here P--dA L.I(CF_ IS'U 4).i(' IAr}rN 02.554icelL
JbU CU1 nLF fi_`U LJ / Q F('L UN Wi�r�lGFNy
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
%,/Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 91$- 5 ID
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER%LESSEE:
CONTRACTOR:
Name it it- 6)`'L"I c InJ U Ri--'
Address: '? �_t1'_i '*rtt r,4 d 4.S R..0 � o
Name: 104N rJ.tnllL a e+-L-
Company: 1'.� TIC hit E CT n r C +tnfo $,2
City: I'_r piPEftCry State:PL
Zip Code: 3 K`I �_1 Fax: _
PhoneNo. 71Z" 911- 91(oY E-
Address: /b4/ Jw SJUI"+ R+(tdu Lk4W
City: Pa rL-f 4r
Zip Code: St/411L/
Phone No ') 1 L'
w C e f_ State: r(-
Fax: ?'1 L-3Yo-D Z
c1U - 3-7gI
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail r
fu rr--
State or County License
6C 13 UU fo 034
IT value OT Construction is ZSUU or more, a RECURDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _c Not Applicable
Name:
MORTGAGE COMPANY: --k Not Applicable
Name:
Address: _
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address: _
BONDING COMPANY: Not Applicable
Name:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
V VV IYCR/ MAI, I l!K Arrl uvII I: 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 or an attornev before commenrinu Wnrle nr rornrriing "n, it AL,+, -- ..•F r
Signature of ntractor - or - Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF Sr Uu c I e
Sworn to (or affirmed) and subscribed before me of k Physical Presence or Online Notarization
this __I day of i:':K-t3 Zp LLr;,y
-To q (" P+'Jle el 9 L
Name of person making statement.
Personally Known \ OR Produced Identification
Type of Ideatification Produced
(Signature of Notary Public- State of Florida)
KONNI LENAE DEWITT
/ ,
Commission No. PlI4(6V) 3H (Seal) Notary Public - State of Florida
Commission # HH 165134
E
My Comm. Expires Dec 10, 2025
ded through National Notary Assn.
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