HomeMy WebLinkAboutPDR.2504.TamarindDr.Ft.Pierce.FireAll APPLICABV INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
c W c 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) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
ALI
Property Tax ID #: S =c�Z(1 j -{l66<_ 2Z Oa 4 Lot No.
Site Plan Name: Block No.
Project Name: sG, Amer
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: Sq. Ft. of First Floor:
Cost of Construction: $ Imer"1G Utilities: -Sewer
Septic Building Height:
OWNERf LESSEE:
CONTRACTOR:
Name ' " (�
Name:
Address: !%
Company:
City: e State:
Zip Code: 3 l' Ll Fax:
Phone No. 30 ��� E-
Address: e �✓
City: ��- ��W i
Zip Code: J j
Phone No i) _gv -
State
Fax:
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Mail-
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail eraJ�ji
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State or County License
- — u"uull 1b c,w ur mere, a rctcuKutu rvotice oT 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:
Zip:
Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: _ Phone:
State
Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
State:
BONDING COMPANY: _Not Applicable
Name: _
Address:
City:
Zip:
Phone:
UVVI-4tK/ LUIN I KAL I UK AFFIUVIT: 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 attorne before commencin work or recording our Notice of Commencement
Si ure ac - or - ner Builder as applicable
STA, OF FLORIDA
COUNTY OF 4141 #1
Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization
this � day of ir2022- by
Sapncm Ct Oec,
Name of person making statement.
Personally Known OR ProducecLldientiif�ication
ro
Type of Identific ion Pced ��
(Signature f . otary blic- State of Florida)
Commissi No. (Seal) aiv"r'�oG
: •`
JOSEUPIA
Notary public - State of Florida
• c`z
commission k GG 215487
'•'� of F�°t'
My Comm. Expires May 8, 2022
Bonded through National NoAssn.
REVIEWS FRONT ZONING SUPERVISOR
PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
CV iV/1G/41