HomeMy WebLinkAboutDEMOLITION PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2-
Permit Number:
Li-
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: �`` ` 0l( Li10n
PROPOSED IMPROVEMENT LOCATION:
Address: _- 1 0-7 0 i Jen:'1 B0-6), EL- -3qq, 7
Property Tax ID #: `A CF5 OS— ND cco Lot No, 3 1
Site Plan Name: Vet:' )(-Cf ( )t Block No,
Project Name: M ncrt
DETAILED DESCRIPTION OF WORK:
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 _ Sprinklers Generator
Total Sq. Ft of Construction:
Cost of Construction: $ �-) 5M -
(Affidavit required)
Sq. Ft. of First Floor:
Windows/Doors Pond
Roof Pitch
Utilities: _ Sewer _ Septic Building Height:
OWNER/ LESSEE:
, CONTRACTOR:
I Name
xa&
Name: jk ia( ivlG>�D�
Company:./1/�PI-1��1
Address: 1o725 J [�bCQ� %
City: State: l-
Address: -3ao �e
Zip Code: 2>��157 Fax:
City: State: -
Phone No. _IJr_ 7E� -� l�o E-
Zip Code: 3Ct Fax:
Mail:_ �CQoCCA(�f Ayn -jr (W') nP "'
Phone No -772-- 22�-ig39
Fill in fee simple Title Holder on next page (if different
E-Mail
from the Owner listed above)
State or County License C'C7C-0ERq f - ,
ii values UI LUIIJU U1.UU11 IJ L7UU Ur more, 8 KtI.UKUtU Notice 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.. State:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name: _
Address:
City:
Zip:
Phone:
')%A/AIrQ / rnhi-rD A!`T^n A rri-I.
— Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name: _
Address:
City:
Zip:,,Phone:
Not Applicable
State:
Not Applicable
- -- - w1 r.. , ,L., V 1, . t+pp„carton is nereoy 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 1 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 attorn Pv hafnrp rr)mmonrin� .,- L — __ ni_io__ r
........�- c�.vi uII Ir, YUUt INUul.e UI t_Ummen cement.
Signature of contractor - or - Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF �fi. LVGI�
Sworn to (or affirmed) and subscribed before me of �` Physical Presence or Online Notarization
this 4'\ day of �I'; r1 r,, 20ZZ by
Name of person making statement.
Personally Known OR. Produced Identification
Type of Identification Produced,
(Sigrature of Notary Public- State of Florida)
Com skit', °RtiKATHLEENGANI)
MY COMMISSION # GG 914400
EXPIRES: January 18, 2024
Bonded Thru Notary Public Underwriters
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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