HomeMy WebLinkAboutBUILDING PERMIT APPLICATION - S Ocean Dr All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
C!C- r't ;
L Q 2 P` ` LD 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: IC 725 .S Ccec"-N Lei-ivy 7t< .Jea-)ncn H e-onGh FL, f!>W l 7
Property Tax ID#: L+511- ': (A-G Lot No. IU
Site Plan Name: UY3m ik UI IQ6C ct /t+['� 6C j Lut Block No. (-
Project Name: CCc-,5ih11
DETAILED DESCRIPTION OF WORK:
CCti v-E- G r)ew s,►1Gle- --cc—yni L, icl nc
New Electrical Meter 1z"' Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit-check all that apply:
/lechanical _Gas Tank —Gas Piping _Shutters -Lxw indows/Doors _ Pond
�ectric 11/111-1umbing —Sprinklers —Generator JZRoof Pitch
Total Sq. Ft of Construction:_ k-IS 3 _ - Sq. Ft. of First Floor: q 17
Cost of Construction: $ 350 �,CC C -C Utilities: X Sewer —Septic Building Height:
OWN ER/LESSEE: CONTRACTOR:
Nameya&,e_I Vk\-i i 4 WQ�c1ta C4t>h11c Name: •41C� K .`VICl-rc!�
Address: 55g1 DU`1C5Ct(-ctf- Company: ;,,1cI- )-::) i T'
City: L—a State: t_ Address: 10�jL:7��• (tit c:.
Zip Code: 3 Fax: City: 1-1Y:�� Stater L.-
Phone No. 5G. 1 - -74-7- 1�317 E- Zip Code: 7 Fax:
Mail: Phone No -1-7 - �2ZCl-C'%L,,13`!
Fill in fee simple Title Holder on next page (if different E-Mail L�Ljt V liC1 'Fw C-C-1 Y)
from the Owner listed above) State or County License C L U'5C1` Q--
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 MORTGAGE COMPANY: _ Not Applicable
Name: Ctadet1 A � 1 C1<Ae i Name: c CiC tom '
Address: 417 -_)e 'L—k • I Address: QqQ `V4 P-Ay—\ Z02.
City: f� State: 'Fy- City: 1<�- -�t�t �_.;��z State: �i�
Zip: Phone ?-72-?751-`SZ:),i�, Zip: Phone: -7-72-- LA 7L4-K1
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY:, Not Applicable
Name: Name:
Address: Address: \
City: City:
Zip: Phone: Zip: Phone:
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 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 attorney before commencing work or recording our Notice of Commencement.
Signature of contractor-or-Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF ==� '
Sworn to(or affirmed)and subscribed before me of Physical Presence or Online Notarization
this2l"'day of RV)"C -u 2022-by
ky-- All M-0
Name of person making statement.
Personally Known OR Produced Identification
Type of dentification Produced +
(Signature of Notary PuIt,c-State of Florida)
Commission No. �� (� (5=NONNVE)
Nrugipap�oB
SIWW00 Aw1HiVA
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 10/12/21