HomeMy WebLinkAboutChristopher Rivera Permit.pdfAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number:
I1�c Wi ItiiUL 'h
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: �AUrr keax� Ao_ordkUn S�rl t erS
PROPOSED IMPROVEMENT LOCATION,
Address: K- kO`1 i_A 1 A � \
Property Tax ID #: CJd 2j ()) \ a (.� (� ��( Lot No. !'—1
Site Plan Name: Block No.PMU 20C.
Project Name:r���QQY
DETAILED DESCRIPTION OF WORK:
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
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction:
Cost of Construction: $ 3 D�y
_ Windows/Doors _ Pond
Sq. Ft. of First Floor:
_ Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE.
CONTRACTOR:
Name_
Name: SaftQ'P ` 70.?G
Company:'3iasa 5j�U*ttr \-t
Address:
City: uu'btj IF I Stater
Zip Code?) 0: p Fax:
Phone No. 'ia, S-1 J J�, C E-
Address: 5\C]N") EMEYCPCEE [)(P--
City�" �- S� t �,IT State:
Zip Code:��Qk(o Fax:
Phone No -In a tq
Mail: \ bye'na 65 CSC \C01�O0 . C`M(2)
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail � ,
State or County License U c`4Q
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 MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
Name: _
Address:
City:
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 an� applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consu t 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 1 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 recorded in the public records of St.
Lucie �ty and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with I r or an attorney before commencing work or recording your Notice of Commencement.
Jill
Si to kof O er/ Lessee/C ractor as Agent for Owner
STATE OF FLO A
COUNTY OF t_ I t-�
Sworn to (or affirmed) and subscribed before me of
'NJ Physical Presence or Online Notarization
this day of i�.&W- , 2Wa' by
':'�) (-Xyv-\ k e,� GZCkl
Name of person making statement.
Pers y Kno _�4_ OR Produced Identification
T e of Identificati n Produced
ature of Notary Public- State of Florida)
Commission No&G aaT eal)
AiYSSA A.T. BOWSER
`
comrnission # GG 295930
}IPExpires
January 28, 2023
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6ondedThr,6,dgetNotary Services
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