HomeMy WebLinkAboutBUILDING PERMIT APP- VERNON STAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3h I 9a Permit Number:
V. L- UCUL"e'
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue: Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: l VvfV10 n +
PropertyTaxlD#; a`a`d�'4053`000'S _ Lot No. Io
Site Plan Name: Block No.
Project Name: _
DETAILED DESCRIPTION OF WORK:
of +\cr h'� 1C. �o �' Ain d1 f7
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 _ Generator )(_ Roof Pitch
Total Sq. Ft of Construction: 1600
Cost of Construction: $ 191006
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height: 4S ^
OWNER/LESSEE:
CONTRACTOR:
NameGAte, 14L EnhyJ?vISt
LL(,
Name: 7OX9'-+ rl#,nht
Address:&(_ W IF1o.w1t✓ 54
54-C 100
Company: Qik %I Rr-)c.YIc.o-,v,� A oqrl!i
City: M % 0., Vn 1
State: FL-
Address: IN H w P+roS i tc,t ItJ
Zip Code: 3311,E Fax:
City: JF01(� L � L&d..,roj*,I C _ , State: _!
Phone No. �§ S , 701 _ Sg 4 0
T E-
Zip Code: 333U 111 Fax:
Mail: 681 L 1+6 hale r ev %5&(& Hatw►ao
1 •Cor
Phone No 615q -7 '2 ' -7i: G S
Fill in fee simple Title Holder on next page
(if different
E-Mail oar Lb a %,0\, &- r I (V%'P- Wcor,
from the Owner listed above)
State or County License__CGG a 65S 7o
if value or 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:
Name: _
Address:
' City: _
Zip:
R: — Not Applica
Phon
State
MORTGAGE COMPANY:
I Name:
Address:
City:
j Zip: Phone:
Not Applicable
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
I Zip: Phone: 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 perm;t.
St. Lucie County makes no representation that is ggrantingg a permit will authorize the permit holder to build the subject structure
which conflicts with any applicable Homeowners 7�ssociation 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 fu ! 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 td posted on t e jobsite before the first inspection. If you intend to obtain financing, consult
with lenftM an attorney h fore commencing work or recording your Notice of Commencement.
- or fowner B ltr as app
STATE OF FLORID "
COUNTY OF V'QL.)D4Y U
Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization
this I day of tAt%VC,h 20_qaby
Name of person making statement. 1
Personally Known X OR Produced Identification
Type of Identification Produced
(Signature of rotary Public- State of Flo
Commission No. (Seal)
REVIEWS FRONT ZONING
COUNTER REVIEW
RECEIVED
COMPLETED
Notary Public SWW of Florida
Marco A Monroy My Commission GG 297622
Expues 0210312a2w^
SUPERVISOR I PLANS j VEGETATION SEATURTLE I MANGROVE
REVIEW REVIEW I REVIEW REVIEW REVIEW