HomeMy WebLinkAboutBuilding Permit App - Christina LantisAll APPLICABLE [INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: "ALZLilt V7 . Z Permit Number:
Budding Permit Application
Planning and Development Services
Building and Code Regulation Divisr.on Commercial Residential
2300 Virginia Aveue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (77�) 462-1578 CESDG Funding
PERMIT APPLICATION FOR:
PROPOSED II
PROVEMEI
Address: ?-V/
c Franc rs ..S;
Property Tax ID #:
1-Yi S'ra
Site Plan Name:
r=rt�r ri s
Project Name:
l�cs�7rcL. r?ti
LOCATION:
.�-fi rt7r �► Lr»: �- �� ti/ �rS L
DETAILED DESCRIPTION OF WORK:
Lot No. Cl
Block No. S
1�1�.r !'�:,_ '; `�.,_► e2 r.u�: �c � '� _ t v I= �'."7rr� PJL �'-� xre�' ,:,� r7r 2 1--N
New Electrical Me er Second Electrical Meter (Affidavit required)
CONSTRUCTI N INFORMATION:
Additional work tc
Mechanical
Electric
Total Sq, Ft of Con
Cost of Constructil
OWNER/LESSE
Name c/ifti
Address: 7 y r c ti
City: POLLI-S= i
Zip Code: yy
Phone No. z-22 .
Mail: I kwky i7et.?
Fill in fee simple T
from the Owner III:
be performed 'under
Gas Tan
_ Plumbing
truction:
n:$
Aiw ,
YlL-CS
,ej
Fax:
v e2pZ,
Holder on In
I above)
_'�
this permit- check all that apply
Gas Piping _ Shutters _ Windows/Doors Pond
Sprinklers _ Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: _ Sewer — Septic Building Height:
CONTRACTOR:
Name: b;4-u,_i, r li4te-cl
Company: A GN�irT
_ State: F1_ Address: 7S-i llu! L-:cerza�/Jt�,rc t z� r0
City: I'M,- Fr L&,ez- State: t=L
E- Zip Code: _ A19Jd Fax: °772-'408 O.Laz
i" Phone No 772 9i2- 02-2-3
page (if different E-Mail ;'U e'4 ,CL AGI•.c� �, ;�
State or County License CGL: e.%-Z7S7i
If value of construction is 2500 or mar , a RECORDED Notice of Commencement is required.
If value of HAVC is $ 500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
QESIGNI=R/E GINEER: `,� Not Applicable Name: MORTGAGE COMPANY:
Address: Name:
City: Address:
State: City:
Zip: Phone Zip: Phone:
FEE SIMPLE
Name:
Address:
City:
Zip:
OWNER/ CONT
I certify that no we
St. Lucie County m
which conflicts wit
structure. Please cl
In consideration of
in accordance with
The following build
accessory structure
WARNING TO C
improvemer
Lucie Count
with lender 1
HOLDER: Not Applicable BONDING COMPANY:
Name:
Address:
HOLDER:
Phone: Zip: Phone:
Not Applicable
State:
Not Applicable
;ACTOR AFFIDIIVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
k or installation has commenced prior to the issuance of a permit,
ces no representation that is granting a permit will authorize the permit holder to build the subject structure
anyy, applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
isult with your Homeowners Association and review your deed for any restrictions which may apply.
he granting of th{s requested permit, I do hereby agree that I will, in all respects, perform the work
he approved plans, the Florida Building Codes and St. Lucie County Amendments.
lg permit applications are exempt from undergoing a full concurrency review: room additions,
, swimming pool , fences, walls, signs, screen rooms and accessory uses to another non-residential use
NNER: Y r failure to Record a Notice of Commencement may result in paying twice for
s to yo property. A Notice of Commencement must be recorded in the public records of St.
an p,o e or the jobsite before the first inspection. If you intend to obtain financing, consult
r n,at r e before Commencing work or recording our Notice of Commencement.
Signature of Con�act - r - Owne' uild r as applicable
STATE OF F
COUNTY OI
Sworn to (or affi
this L7 day of
DA
Si' LU�[L
ed) and subscrib d before me of X_ Physical Presence or Online Notarization
�rr2ct'� , 2Dz? by
l�i:l-r2rtrt=lL ��CLL `f
Name of person making statement.
Personafly Known ')(- OR Prod ced Identification
TyRe of ldentificati l( Produced
(Signatc of Nota y Public- State Florida)
Commission No. 9 2 (5 alj
___T�
REVIEWS RONT ZOIWING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
pd Nctari Public State of Flonda
Crystal E Naybn
i My Conrrr(ssion GG 929,W54
pry�tl' Expires 11;06/2023
SUPERVISOR PLANS VEGETATION SEA TURTLE
REVIEW REVIEW REVIEW REVIEW
MANGROVE
REVIEW