HomeMy WebLinkAboutpermit 7505 fort walton aveAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
L o is a to rc -
Planning and Development Services Building Permit Application
Building and Code Regulation Division
1300 Virginia Avenue, Fort pierce FL34982 Commercial__` Residential �C
Phone: (772) 462-15S3 Fax: (772) 462-1S78
P MIT APPLICATION FOR:
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PROPOSED IMPROVEMENT LOCATION: —�
Address:_-7SQS toY-I- w444an �4 It
PropertyTaxlD#: )3�(_ E,o6-,p1gy_
Site Plan Name:
Project Name: - Block No.
rDETAILED DESCRIPTION OF WORK: — — —
% czc c'1Ff pki5�ina rnnr and all nALVJ
Q on,C'tz -fat ., 5 In4 S
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
_Windows/Doors _Pond
_Generator X Roof `/',
'/
Total Sq. Ft of Construction: /Sa 7
� pitch
Sq.
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Cost of Construction: $ Sp0
Ft. of First floor:
Utilities:
OWNER/LESSEE: —
—Sewer _Septic Building Height: 1
—
Name ��%ZGb��i1 H.��nC-<.
CONTRACTOR:
Address 7�OS Yar } 1 I 1
Name: r_i g/1 f,�p n0
o �� Ave
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Company: r
do in
State:
Zip
Zip Code: 3495 1 Fax:
Address: ! (; S W 1 , 51, -
Phone No.� I (�' �/ 74^ y q Ce3
City: r} .�. C/L State:(,
E-Mail:
Zip Code: 3C-/5d<( Fax:
fee simple Title Holder
Phone No 7%a- 10 _ c�%��
LFin
on next page ( if different
the Owner listed above)
E-Mail TCm
State or County LicenseCC (, I'��� S
If value of construction is Z500 or more, a RECORDED Notice of C I mIs required.
mencement
If value of HAV[ is $7,500 or
more, a RECORDED Notice of Commencement Is required.
DESIGNER/ENGINEER:
Not Applicable MORTGAGECOMPANY
Name: Not Applicable
Name: _
Address:
Address:
City: State: City:
Zip: Phone Zip: Phone: State:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY:
pble
Aplica I Name:
—Not
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 is in conflict with any applicable Home Owners Association
rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners 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 attorneybefore commencing work or recording your Notice of Commencement.
Signature of Owner/ Lessee!C7 tr ct as Agent for Owner Signature of Contract r/Li s Hold
STATE OF FLORIDASTATE OF FLORID
COUNTY OF� ZsJ GC
COUNTY OF —
sworn
sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notariza
sworn to (or affirmed) and subscribed before meHit
(, Physical Pre ce or Online Notarization
this clayof2020 bythis—q_dayof !alb 2020 by
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Name of person making statement. Name of person making statement.
PersonallyKnown OR Produced IdentilPersonally Known ''C OR Produced Identificatio Type of identification
3 3 � Type of Identification o o ,.
Produced w — m < Produce 3 3
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(Signature of Notary Public- Sta[e o } w » -
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- Commission No� N ° o
(Seal) Commission No
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REVIEWS FRONT ZONING i S PLANS i VEGETATION SEATUMir
RTtE MA GR E
COUNTER REVIEW REVIEW REVIEW
REVIEW R
DATE
RECEIVED
DATE
COMPLETED
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