HomeMy WebLinkAboutReif Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 317 I107-z- Permit Number:
g .. 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:
PROPOSED IMPROVEMENT LOCATION:
Address: -7206 Santa
f r C T(k
Property Tax ID #: f(77 I �0 - 61 1- 00�'6 - 000 - O Lot No. � t
Site Plan Name: l elf 2e- boe Block No. Q
Project Name:
DETAILED DESCRIPTION OF WORK:
4r1AGI?_ KOAI-' f, Q PAId.LP L,lI
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
Additional work to be performed under this permit -- check all that apply:
Mechanical _ Gas Tank — Gas Piping
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: 2.4W0
Cost of Construction: $ 2- 1, �00
Shutters
Generator
Sq. Ft. of First Floor:
Windows/Doors _ Pond
/Roof 5 Pitch
Utilities: —Sewer _ Septic Building Height: 1 Z
OWNER/LESSEE:
CONTRACTOR:
Name Sean Relf 'n 000E
Name:
Address: 7200 a d
AAAA
Company: Elbii&
kOQ�IA� � n�fL1Gr�01'
City: T lacy- State:
Zip Code: 3q9q Fax:
Phone No. E-
Address: 3qO() _q_ 31A
City: VerO Rgac k
Zip Code: ,3Zq�0
Phone No 777_ - q53
AWAY L. Su 4
State:
Fax:
- _7Z I R
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail CSA M
_
CO
State or County License C e
_
I S?_ 63
If value of 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:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
City:
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 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 roperty. A Notice of Commencement must be recorded in the public records of St.
�L ei� o my and st d the jobsite before the first inspection. If you intend to obtain financing, consult
t11 le er or atto {4ney efore commencing work or recording your Notice of Commencement.
Signatur of Contractor - or - 0 r Builder as applicable
STATE 0 FLORIDA
COUNTY OF �hdIQ_4 Q t&,i'
Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization
this 7Tll day of In� 20.-AO- by �P+'12 C's
Name of person maki g statement.
Personally Known y OR Produced Identification
Type of Identification Produced
(Signature of NotarQyQPuubli - tate of Florida)
00 Y?u
Commission No. 1 (seal) � c. MAPUA DE JESUS LOPEZ
MY COMMISSION # GG 988122
EXPIRES: July 25, 2024
°FOF Bonded Th. Notary Publie Underwriters
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev1u/1Z/Z1