HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO.MUST BE COMPLETED FOR APPLICATION TO BE.ACCEPTED
Date:
PermitNumber-
-Buildling Permit Application d l
i
Planning and Development Services
Building and Code Regulation Division COn'1inerCIal Residential V
2300 Virginia Avenue;Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772):462-1578 CBDG Funding
PERMIT APPLICATION FORT
PROPOSED fMPROVEMENT LpCATION`;. :
i
/-
Address: 1-1.1 S /V 1!V G ECEA/13,2 I E R LI 7 /-�rM `�a �"! /I-- . . ..
Prope.rtyTax I;D#s .L4 y2�"= Di �0 o :0130-3 Lot No.
Site Plan Name.: Block_No.
Protect Name t .1_ IJT RES 90C»)
DETALLED DESCRIPTION OF WORK:
1�I~ AW"P TN E V2 NOL-6 140U S c. F90" VLO PP)_r AYA—)1 pall
77 Lfe7 C FI.yT 77.C-E5T —
New Electrical Meter Second Electrical Meter (Affidavit required)
I '
C:ONSTRUCT(ON INFORIVIATFQN
i
Additional work to be performed under this permit-check:all that apply:
_Mechanical _has Tank —Gas Piping _Shutters. _Windows/Doors _Pond
g — P i/oof 5` 2
_Electric Plumbing Sprinklers _Generator Pitch
Total Sq. Ft of Construction:,-4 b*'qb Sq..Ft. of First Floor: tl'))9'10
Cost of Construction:$: 44,000-:7 Utilities: `Sewer _Septic Building:Height: Ile'
OUVNERJLESSEE
CONTRACTOR:
Name -J'L-)14INS .(-001!)LE T2-- Name: ..T24tvetcco ClC.W4
Address: 2 t1Y3 Ltj Compahy: 20OMAV:el2l LI-C
City: !4LM a✓1(� Y . State L . Address: 75r.&Vtj I W q �� tUAy
Zip Code: q qq o Fax: City:. 'sun-a:1 SE State: t=1;-
Phone No. 4`M .33 3 GgC> E Zip Code: 33 323 . Fax; �3Ss-t UigCr�5)6.9 :
iViail: JO�+n1COb�(t,�. h0-tmct"l e bw�. Phone No
Fill in fee simple Title Holder on next page(if different E-Mail lr`6b-fo 2r e VeY' @ -Lfl So y r P
from the.Owner listed above) State or County License GcG t32-7£33� _
If value of construction is 2500 or more,a RECORDED Notice.of Commencement:is required.
If value:of HAVC is$7,50[1 or.more,a RECORDED.Notice of Commencement is required.
I
__ I
DESIGNER/ENGINEER; _Not.Applcable MORTGAGE COMPANY: Not'Appilcable H
Na'rne: Name:
Address: Address:
City: State: City.: State
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: 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 ggranting a permit will authorize the permit holder to build the subject structure:
which conflicts with anyy.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 p perty. A Notice of Commencement must be recorded.,in the public records of.St.
County and p6svegl&n the jobs.ite before the first inspection. If you intend to obtain financing, consult
ith)e r an attorneV before commencing work or recording our Notice of Commencement.
Signature of Contractor-or owner Builder as applicable
STATE OF FLORIMA
COUNTY OF IJ `C)U—n rd
Sworn. o(or affirmgdl�ncd-ubscribed before me of ---Physical Presence or . Online Notarization
this dayof. ,/� 20: by �'r-lq t1Ct�v C��I
Name.of person making.statement. /
Personally Known OR.Produced Identi6' tion t!
Type of I entificat n.Produced ��/P r Pn�
(Signatu a of.Nota Public-State of Florida)
M1tgY PUB
Commission N'o.A)A211*75 (Seal) 2°.•�••.,�% YUDERQUISCOELLO
* * Commission I HH 210413
Expires December 21,2025
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev: