HomeMy WebLinkAboutPermitApp.pdf5.7/t, r z? zYyT?e--
All APPLICABLE MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: Otq d { Permit Number:
Building Permit Application
Planning and Development Services /
Building and Code Regulation Division Commercial Residential V/
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:lrlcF
'PROPOSED IMPROVEMENT LOCATION:
Address: gad$ CX00AMOIJ
LN Bar SAEOT tuer_E�
Ft 3tJ� Q�
Prope rty Tax I D ff: 3 y2 5 '?o l -(j y -n�f2►
Lot No.�
Site Plan Name: Block No.
Project Name: 3TAAAg £S_ZIDENCE
DETAILED DESCRIPTION OF WORK:
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New Electrical Meter Second Electrical Meter
i CONSTRUCTION INFORMATION:
ditonal work to be performed under this permit -check all that apply:
Ad�cm
echanical __ Gas Tank Gas Piping Shutters Windows/Doors Pnnd
E!ectnc _ alumb.ng — Spr inkiers — Generator _ Roof Pitch
Total Sq. Ft of Construction: Iss4 (WOeR As0. Sq. Ft. of First Floor:
Cost of Construction: $ (051.1 Do Utilities: —Sewer —Septic Building Height:
F OWNER/LESSEE: CONTRACTOR:
_ _
i Name ?PDactt"1. Name: KARK VTMFS - -
- i
Address: 2?,S GLNNP� 1 L� Com an
----- ---- - --
::: �Oi�T tS IwIT LU�CLE F(- = aS�� S MT-t_%rAAY TAL
Zip Code: �gJr� -_ Fax: C ,, WEST PAU1 3EAQ4 :'.. f--L
Phone No. 727Q--- __—_— Zip Code: 33 l Fa> ---- - —
I E Mail:
Fill in fee simple Title Holder on next page ( if different E-Mail_ n0(m%!SQ ate'{ LAG . C ON'l
from the Owner listed above) State or County Lirrnse_C ,_0g a.sa ___ _
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If value of construction is 2500 or more, a RECORDED Notice of commencement is required.
It value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEM
i Name:_
Address:
City:
Zip: —
19
FEE SIMPLE TITLE HOLDER:
Name:
Address:
('itv
Zip: Phone:_
LIEN LAW INFORMATION:
State
Not Applicable
MORTGAGE COMPANY: ✓ Not Applicable
Name:
Arirlracc-
City: State:
Zip: Phone:__.
BONDING COMPANY: ✓ Not Applicable
Address:
City:_
Zip: _
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 County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in structure. Pleaseconsultwith your Home Owners Owners Association
reviewylaws or your deed for any restrict that
which may aor . prohibit such
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 recordin the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you inters to obtain financing, consult
with lender or an attorney before commencing work or recording your Notic of Commencement.___
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Ce
STATE OF FLORIDA STATE OF FL
COUNTY OF Zn 1 UCZE COUNTY OF
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of
Vh,
(or affirmed) and subscribed before me of �'1 Swor (or affirmed) and subscribed before me i
ohysi I Dracanre nr nnlinP Notarization
sic,ai Pre$@Ille Or ,
day of t4ARJ:.4I , 202P,by this day of �A�iC�— , 202i�by
ASE2i V ! WK A VTNE�
Name of person making statement i Name of person making statement.
Personally Known --Z- OR Produced Identitcaton Personally Known V/ OR Produced Identification
Type of Identification Type of Identification n
ature of
Commission NoGG._OLB-9
My Commission GG 339912
EFRM p5/29/2023
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE - - - -
RECEIVED
DATE
COMPLETED
Rev.3/b/2C -
Id
State of
339912
SUPERVISOR PLANS VEGETATION SEA'TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW