HomeMy WebLinkAboutSt Lucie County Permit - Cliff CooperAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: MAAcH 3 - a Permit Number:
J11ro PL I CLL _.
P Building Permit Application
Planning and Developmer t Services
Building and Code Regula ion Division Commercial Residential
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
k
PERMIT APPLICATION
FOR:
PROPOSED IMPROVEMENT
LOCATION:
Address: 8 3o i PA5 , l i<DLicL•-L(; i
Property Tax ID #: i 3t3r 4-40V d
Site Plan Name: Coop FL-Aax*
Project Name: ens s PVC e=crtlt
DETAILED DESCR[ TION OF WORK:
I
_Sr Lv 4uL bit TL S
LL.
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
Lot No. 2 4
Block No. 4C,
Additional work to be pe'formed 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: $ IR, 6 RrJ r Oc-) Utilities: _ Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name CgLee`'F'
Address: k zui Agx6
City: 970.L:: torl_1LCL
Zip Code: -?IVPS-f
Phone No. i7? ajY
Mail: 6 r_C__ 5"791Q
Fill in fee simple Title Holder
from the Owner fisted a
Name:
Company: ;M fry m at
State: FL
Fax: -172 1408 �27
fo1_i E-
Address: 7-5-1 . JLJ
'
y: State: iq-
City:
Zip Code: .r' Fax:' 12- Yy i'2_7 Z_
Phone No Zit_ 812- 0,.z-2�
on next page of different
ove)
t
E-Mail lit. F0 0- A Cej
State or County License Q—.0 ds 2-i S 7f
l7 Value Or consiruction is 1 uu or more, a KLUMULD Notice of commencement is required.
If value of HAVC is $7,500 r more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL C
DESIGNER/ENGINEER:
NSTRUCTION LIEN LAW INFORMATION:
Name: _
Address:
City:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address: _
City:
Zip: Ph ne:
Y Not Applicable
State:
Not Applicable
MORTGAGE COMPANY:
Name: _
Address:
City:
Zip:
Phone:
Not Applicable
State:
BONDING COMPANY: Not Applicable
Name: _
Address:
City:
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 r presentation that is granting a permit will authorize the permit holder to build the subject structure
which conflicts with any ap Itcable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult will h 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 ur property. A Notice of Commencement must be recorded in the public records of St.
Lucie County an sted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender r, n to ne before commencine work or record inia, our Notice of Commenc t
emen .
r - C1 ner Builder as applicable
Signature Co ractor
STAT OF FLORID
COUNTY OF
U_�,C_
Sworn t9 (or affirmed) an
this:_ day of
subscribed before me of V Physical Presence or Online Notarization
20Z&y
,� )L'
Name of person making st
tement.
Personally Known
OR Produced Identification
Type of Identification Produced
(Signatur f otary Publi
- State of i a)
Commission No. '
eal)
,a** Notary Public State of Florida
Crystal E Naylon
My Commission GG 929549
or Expires 11106/2023
REVIEWS
FRONT
COUNTE
R
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
m_ 7
I -)