HomeMy WebLinkAboutJason Permit 69 Golf Drive.pdfAlIAPPTICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3 "3> -aa Permit Number:
Planning ond Development Services
Building ond Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (7721 462-1578
Building Permit Application
Commercial Residential
CBDG Funding
hH-.#
PERM IT APPLICATION FOR :
PROPOSED I MPROVTMENT LOCATION :
Property Tax lD #:
Site Plan Name:
Lot No
Block No.
Project Name:At c'llAt-tct{ c,7
DETAILED DESCRIPTION OF WORK:
3 .€+o.,-, /4 Sce,- fn." '.r,o u -. I u,r; fL i)lLu A er-,kt
New Electrical Meter Second Electrical Meter (Affidavit required)
I|Coyrlr*'o*,*ro**oTlo*' ,
Additional work to be performed under this permit - check all that apply:
Y/Mechanical
-
Gas Tank
-
Gas Piping
-
Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Sq. Ft. of First Floor:Total sq. Ft of construction:
cost of constru*ion: S 5:* o<; ' uC Utilities: Sewer _ Septic
Name L,)uLa
Address: 1,,? (;",ff be
city: 75 L State: FL
Zip Code: 3'115? ra*,
phone No. 7 7A - ,ytl - i/t I g
Mail: L i.,-La €ra,eS 6'lC-1" (<i ."-r
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
lf value of construction is 25fi) or more, a RECORDED Notice of Commencement is required.
lf value of HAVC is S7,5OO or more, a RECORDED Notice of Commencement is required.
Windows/Doors _ Pond
_ Roof _ Pitch
Euilding Height:
OWNER/LESSEE:CONTRACTOR:
€rr
ZipCode: 3LiqE3 Fax'
Phone No '-7 ) 9 - 3 AA :i& -)
State or County License
)oid 7) 6).,eAddress:
Address:
INEER: F/ Not Applicable MORTGAGE COMPANY: fNot Applicable
Name:
FEE SIMPLETITI.E HOLDER: @ Not Applicable
Name:
BONDING COMPANY: _vf,lot Applicable
Name:
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 permit.
St. Lucie Countv makes no representation that is erantins a permit will authorize the permit holder to build the subiect structure
which conflicts with anv aoplicable Homeownersassocia"tioh rules. bvlaws or and covenants that mav restrict or pr6hibit suchstructure. Please consult with your Homeowners Association and ieview your deed for any restractions which may apply.
ln 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 5t. 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
of Contractor - or - Owner Builder as applicable
STATE OF FLORIDA-^I ,
COUNTY OF -9T LUL4T
Sworn to (or affirmed) and subscribed before me r
this uday or /rtr#- .zozhv *--K*atPresence or-
ldentification
ilof Notary
Commission No.
STATE OF FLORIDA
Comn# GG262780
Expiros gn0l2022
VEGETATION
REVIEW
DATE
COMPLETED
Name:
Address:
City:State:
zip
Address:
City:
Zip: _
Address:
City:Zip:_ Phone:
Address:
City: _
7ip: _Phone:
Name of person making statemjnt.
Personatty *nr*n .ouJl,rroo
Type of
Beverly J. Procke