HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE coiv___sED FOR APPLICATION TO BE ACCEPTED'
Date: 3l ``�'a� I SCANNED Permit Number: ab3 dS�
RECEIVED
21To L�1C��L - �� @.�c�fnuntiv
a 1
• MAR 1 ,9 1011
7-
Building Permit Application Permitting Department
St. Lucie County
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
I
PERMIT APPLICATION FOR:
S4, rlC-., S 1�
'PROPOSED INMPRO.VEM!ENT'LOCATLON;
Address: j'31� Sc�u h .aA al Try, ilk Ed �i efc-zeFL, 3Y4S�/
Property Tax ID #: 2_ -O O 1.00 Lot No.
Site Plan Name: `L', G r e L�QBlock No.
Project Name: %Le at,e J-c'h"Toig o-7 1341Td E
OETAILED DESCRIPTION OF WORK:
New Electrical Meter3c-*4_Second Electrical Meter/!
CONSTRUCTION INFORIVIATIO:N:
Additional work to be performed under this permit- check all that apply:
�rWechanical _ Gas Tank _ Gas Piping _ Shutters _Jr- Windows/Doors Pond
xflectric 47Plumbing _ Sprinklers _ Generator woof 411 Z Pitch
Total Sq. Ft of Construction: I' 4 ! 4C, � ! Sq. Ft. of First Floor: 14�%� � , F r, ff
c
Cost of Construction: $ j/T�i, n Utilities: _Sewer ! Septic Building Height:
j OWNER/LESSEE:
CONTRACTOR:
Name MILOa i� 13r�S:`Lei �i,`LCv �`�� �sc�n
Name: ffierk M.7;;orj,-1--,o
Address:f & O3 5_&_/9Zqn dd.
Company: / i7Gn,2'e_'k�i < [n c
City: 1;�r-+ P"efC<_ State: ,
Zip Code: y�{q'-✓�/ Fax: M&
Phone No. -7 Z2- 51M -0 3 114
Address:_X0 I <f L
City: RT L Stater
Zip Code: 3 4l 9'T4i Fax: 1Y 1A
Phone No
E-Mail: e-1-
Fill in fee sim a Title Holder on next page ( if different
from the Owner listed above)
E-Mail SL . e-017)
State or County License
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.
ISUPRLEMENTAL CQNSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _"Not Applicable
Name: Ve- 4- i Name:
Address:
'�,SS' ` Address:
City: - ;� tate:f� City: State:
Zip: Phone 719 —M -010 Zip: Phone:
FEE SIMPLE TITLEHOLDER: _2r_ Not Applicable BONDING COMPANY: ArNot 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 granting a permit will authorize the permit holder to build the subject structure
which
ructure. Pleasle consult withp our Home Owners Asso Association andrreview your deed for any restrithat
t ons which may alprohibit 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 recorded in the public records of St.
Lucie County and posted on he jobsite before the first inspection. if you intend to obtain financing, consult
with lender pr aryattorne efol;�commencing work or recording pur Notice offyommencement.
of
Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF `ST, "CI- COUNTY OF ST LGIP
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this � day of YYIAy C Jn , 202$ by
Sw n to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this (today of I(Yi VY-k- 202p by
1M+�� VYXmiA 1`I�
IMiAry- IM&Mih 1 TO
Name of person making statement. Name of person mak�in/g statement.
Personally Known_ OR Produced Identification Personally Known %
Type of Identification Type of Identification
PProduced
roduced
(Sig a cure of Notary Publi SR i;FlR-66MIa Mwen (Signature of Notary Publi
• My Commission GG 296212
Commission No.
w Ex iJ28 04/2023
C7 Commission No. C-C—
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION
COUNTER REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
OR Produced Identification
FI®oWa 4 Bowen
My Commission GG 298212
SEATURTLE MANGROVE
REVIEW REVIEW