HomeMy WebLinkAboutmunson permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3I-1 12oZ2 Permit Number:
S�Y, LLIc
a 71010000L., 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:
1 PROPOSED IMPROVEMENT LOCATION: I
Address: ) 1 -115 VL v MI f
Property Tax ID#: 3Vq- bo l�
Site Plan Name:
Project Name: KIIS
IWATAMM
106 Dr►Vt
DESCRIPTIONDETAILED OF ••
fir'IAI ' .. -1� 1 o6",a05'�1 riiiT!��� I OR
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit - check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _
_ Electric _ Plumbing `— Sprinklers _ Generator
Total Sq. Ft of Construction: - 7w Sq. Ft. of First Floor:
Lot No. 7
Block No. R
_ Windows/Doors �-_ Pond
Roof ) 11 L Pitch
3700
Cost of Construction: $ Utilities: —Sewer —Septic Building Height: Z�
OWNER/LESSEE:
CONTRACTOR:
Name
Name: V
Address: 111 % 15 r) 0
Company:
Cit(21C), r Q State: _ff,
Zip Code: aw9s-i- Fax:
Phone No. E-
Address: 1
City: State: a_/
Zip Code: Fax:
Phone No "
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail rl C
State or County License
n value ul wnserucz'un is cDw or more, a xMunucu notice or commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
NEER: A Not
Name:
Address:
City: State:
Zip: Phone
MORTGAGE COMPANY: �Vot Applicable
Name:
Arld rpcc
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: of Applicable I BONDING COMPANY:
Name:
Address:
City: _
Zip:
Phone:
Name: _
Address:
City:
Zip:
Phone:
Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to ao the worK anu uoiauauvu a�
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
wi*L. Ionrlpr nr nn nfTnrrmpv hpfnro rnmmpnring work or recording vour Notice of Commencement.
Signature o Contractor - or - Owne uilder as applicable
STATE OF FLORIDA , f
COUNTY OF I Ul
Swor (or affirmed) subscribed be�pJ�e me of
Physical Presence or _ Online Notarization
this day of 20C Lby
Name of person making scat ment.
Personally Known � OR Produced Identification
HAVENS aYHH199309Type
of Identificatl d d
04, 2025State Insurance
oft
(Signature of ota rc- ate o a)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 10/12/21