HomeMy WebLinkAboutMondello Permit Application-ElevatorAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: � - - 2-2- Permit Number:
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: C ,_F 0 i q- , 0,.^, �__
Address: k A 1'1W U-Di v,TE t1 'Z, 0_4Lc E- 4---
Property Tax ID #:
Site Plan Name:
v t - C)= - C)OLD -- Z
Project Name: ��v�Jr• r_>E LLCM
DETAILED DESCRIPTION OF WORK:
X
Lot No.
Block No.
} i��_ Lt_ ���r✓ \ c,��-tCI_ �� 4— 1= CE-
New Electrical Meter Second Electrical Meter
(Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
_ Electric _ Plumbing _Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ k7 C_C_). (_�O
Name VirV'- rt-,'FN-L0
Generator
Sq. Ft. of First Floor:
Roof Pitch
Utilities: —Sewer —Septic Building Height:
Address: \-2Z-- huD iJl��rTEt1 S I EE�GfI.i
City: ^,�� State: _
Zip Code: _340q) Fax:
Phone No. 7-7 Z - - ZZc)A E-
Mai1: hJl C>&k__L U ( C�-_) RVVNAi L C�"w
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name:E' k__
Company-i-G L� '(—� fl.t C LL
AddresstMi37 �_ >Z LEX,rG Ic�r• �—
City: t�CXL\ s\ L(-1 G E- State: "��--
Zip Code: =7�5k(::� 75� Fax:
Phone No--1-7Z - ---'A4- q !SS
E-Ma r-LC-C 1(L.,0 #- t_ � � L ,C
State or County License l
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
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
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 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 FLORI
COUNTY OF i Lim C-
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this � day of Y1� -A f1._ , 20 Z�y
Name of person making statQment.
Personally Known ,/ OR Produced Identification
1pe Identificati�Pruced
(Signature of Notar blic- State of Florida)
1 + Notary Public State of Florida
Commission No l-��(7, ¢Seal)
Myyccommission HH 107363
�Irw� Expires03rMO25
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev l0/12/21