HomeMy WebLinkAboutBLDG PERMIT APP 3775 WILD ORCHID LNAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE
ACCEPTED
Date:
Permit Number:
L-LI.�LL
BuildingPermit
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
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: (, LN
Property Tax ID#:
rot No.
Site Plan Name:
Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
r 2
n o-Q
�naltr �o 4 AALJ
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that
ply:
_Mechanical _ Gas Tank _ Gas Piping _Shu
ers -Windows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers _ Ge
ierator Roof VIJ Pitch
Total Sq. Ft of Construction: 59 1 a Sq. Ft. of
First Floor:
Cost of Construction: $ ycl, 000 Utilities: —Sever
—Septic Building Height: a
OWNER/LESSEE:
CONTF
ACTOR:
Name Qir in kIe
Name:
Compan
Address
iepn
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Addre5s:3'-(`js W j 18 Qf(l d nl
: rQ Co a
City: _ ov `} ! Q {Q, L State:' t
1
Zip Code3yq'al Fax:
City:
yj- rJ'r. State: L
Phone No.
Zip Cod
3 c(9 A(4 Fax:
E-Mall:
Phone N
%'. 1- O - 0
C, a oD S h L..L
Fill in fee simple Title Holder on next page (if different
E-Mail
County License C G
from the Owner listed above)
State or
If value of construction is 2500 or more, a RECORDED Notice of Cornmencen
ient is requlred.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement
required.
DESIGNER ENGINEER Not Applicable MORTG
GE COMPANY: Applicable
Name: Name:
_Not
Address:
Address:
City:
City: State:
State:
Zip: Phone
Zip:
_ _
Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDINi
Name: Name:
COMPANY: _Not Applicable
Phone:
a permit to do the work and installation as indicated.
Address:
Address:
City:
City:
Zip: Phone:
Zip:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to clotaiii
I certify that no work or installation has commenced prior to the issuance of a
permit.
St. Lucie Count yy makes no representation that is granting a permit will authori
which is in conFlict with any applicable Home Owners Association rules, bylaw
a the permit holder to build the subject structure
or
structure. Please consult with your Home Owners Association and review youi
and covenants that may restrict or prohibit such
deed for any restrictions which may apply
In consideration of the granting of this requested permit, I do hereby agree th
it I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Luci
a County Amendments.
The following building permit applications are exempt from undergoing a full
ncurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and
cessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commenciinnent
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 inspec
ion. If you intend to obtain financing, consult
with lender or an attorne before commencing work or recording
our Notice of Commencement.
�
f
f Contrac or ce se H der
/Co actor as Agent for Owner Signature
Signature of Owne CP4
STATE OF FLORIDA STATE 0
FLORID L
COUNTY OF COUNTY
OF 6�r. LvGc
Sworn to for affirmed) and subscribed before a of -, Sworn to (
r affirmed) and subscribed before me of
X Physical Pre ence or Online Notar ati �_ Physical
Presence or Online NotanzH
'
thit1dayof fafC►, 2020 b this,S
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yof V)PACcL. 2020 by"1
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Name of person making statement. 3 3 Name of person
making statement.
Personal) Known 3 3 <
y OR Produced Identi caii�t Personalty
Known 'S' OR Produced Identifi
Type of Identification Z m � Type of Id
ntification
Produced o x m y Produced
F
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"ISignature of Notary Public- State of Florid ) iS c ignature
of Notary Public- State of FI ida) o x a
Commission No. S ��a— (Seal) ro Commissio
i No. �lz (Sea A o F.
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REVIEWS FRONT ZONING 1 SUPERVISOR
PLANS
N Pa a
VEGETATION SEATURTLE MA OV
COUNTER REVIEW REVIEW
REVIEW
REVIEW REVIEW
GATE
RECEIVED
DATE
COMPLETED _
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