HomeMy WebLinkAbout751 NE Prima Vista permit.pdfAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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Building Permit Application
Planning and Development Services "Y
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierre Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address:—I51 lk )JE � IN^01 vtl k WU
Property Tax ID #: 3Y A - SIG - Ol a 4 - (O" + Lot No.�
Site Plan Name: Block No. dtT
Project Name:
DETAILED DESCRIPTION OF WORK:
i
L- 30310 -1'Z2, l k rot-5 P D o I e
f
1. - 34 6m
- &!(on 5rlws , �,' bL��f GrG?r'1VIG� (�er{ayMtA+
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/Dooms _ Pond
_ Electric _ Plumbing _ Sprinklers _ Generator ,Z Roof J �2 Pitch
S Q
Total Sq. Ft of Constructto :I O 1 Sq. Ft. of First Floor:
00 IC i
Cost of Construction: $ Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name NUrI , 5 Wr�n�� Name: I I (
AddresscAt Di ShIY6 V2. AA It( Company:M Ot ,(QY�
City: State:Address: S
Zip Code: Ts I Fax: City t?n�&C A _ State:
Phone No."ina'All-13-7 E- Zip Code 3�, Fax:
Mail: Phone No
Fill in fee simple Title Holder on next page (if different E-Mail �' e `i W)
from the Owner listed above) State or County License
If value of construction is 25W or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,S00 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: „r Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Tip: Phone
Tip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
i /A��d��d'�ress:
1 City:
AddreAddress:d��ress:
`•'�r
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFROVIT: Application is hereby made to obtain a permit to do the work and installation as i rimed.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no lion that is sting a permit will authorize tfre permit holder to build the subject structure
w!uth conflicts with any a e HHomeowmers Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please eonsu 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 puns, the Florida Building Codes and St. Lucie County Amendments.
The foflowirq building permit apgiitations are exempt from undergoing a full conturrency review: room additions,
accessory structures, sw9mrnft 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 roperty. A Notice of Commencement must be recorded in the public records of St.
Lucie County on the ' e before the first inspection. If you intend to obtain financing, consult
with lendaf v beffiWcoInmenciniz work or recording your Notice of Commencement.
Stfatufrof Owner/ ttcr as Agent for Owner
STATE OF FLORIDA
��
COUNTY OF LA c
Swom to (or affirmed) and subscribed before me of Y Physical Presence or Online Notarization
this = day of AJO j6 .2Q,mVby
Nate of person making statement_
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Personalty Known OR Prod Identification V
Type of Identification ProdGEL=
W9&4
(Signature of Notary Public- St to of )
Commission No. (Seal) �uA MvA
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t #Ay Cwm Eow" Nov 7. 2021
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