HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COW-? . <D FOR APPLICATION TO BE ACCEPTED
Date: I M E itr er:
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' Building Permit Application AUG 0 5 202,
Planning and Development Services . 8t Luele County
�� s Residential Permitzio
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce Ft-34982 SCANNED
SCANNED
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: ucle comw
h.3�.P'S"'1130 ^.y k" 7"6- .h
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Property Tax ID #: Lot No.
Site Plan Name: fX t3HA V I JrAJ LX0-fT -Y Block No.
Project Name: LA uA 1-i w [PA L-
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New Electrical Meter Second Electrical Meter (Affidavit required)
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Additional work to be performed under this permit -check all that apply:
_Mechanical Gas Tank —Gas Piping _ Shutters —Windows/Doors _ POA4
'�-I Electric _ Plumbing Sprinklers _ Generator _ Roof Pitch
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Total Sq. Ft of Construction: q.L C + r! Sq. Ft. of First Floor: t'yO0 Sb ! I
Cost of Construction:$ a-�000 Utilities: _Sewer _Septic Building Height:
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Name �' �Il CALO� o
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.Name: XV mopi 6a?- 't
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Address J�%ao /J I✓ ` � bt`✓�y )S
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•'Company:Fi' --/ CO1s`,2uc<�or� !PC,
Address: `" % I41 w' �Af pp-q OQ J
City: Po/ l�/S'f% L WC,i ✓ Stater
City: p0/tr .f-f Lu cll' Stater
Zip Code: Fax:
Phone No. -777+ - rF/`� �'i
Zip Code: y al Fax: N A
E-Mail: �'At19/jeoj4!'Q//G l%7MasL•eo
PhoneNo%7'%-6�-�`-06�
Fill in fee simple Title Holder on next page (if different
E-Mail VJ Giti b ('' aNy'f KuG )°„ . lrOM,.'
State or County License C t3 C 1-3,6 Lir-1 6 t
from the Owner listed above)
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. .
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DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY: \r Not Applicable
Name: poN .i 14 f!
LL1-. 10 6.
Name:
Address: 116 3 S i l- /'.a • .N A
Address:
City: P0, _' sT- Ltaci�
State:
City: State:
Zip: Phone-Sc /-
6a 9- 9 7,,A
Zip: Phone:
FEE SIMPLE'TITLE 'HCILDEF6
Not Applicable
BONDING COMPANY: Not Applicable
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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 priorto 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 conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners 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 property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attornev before commencine work or recordine vour Notice of Commencement.
Signature of Ow er/ e e for as Agent for Owner
STATE OF FLORIDA 11
COUNTY OF
Sworn to (or affirmed) andsubscribed before me of 7/Physical Presence or
this --M day of X7�(9 (/71 2011 by
Name of person
Personally Know ✓ OR Produced Identification
Type of ldentificatpVn Produced / a
(Signature ofNetavPublic- S,t/ate of Florida )
Commission NJI H QXi 71 Q (Seal)
REVIEWS
COMPLETED
FRONT ZONING
COUNTER REVIEW
Online Notarization
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Notary Pao4c State of Flonde
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Samantha M Polito
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My Commna�on MN 004774
Esprteg05/]82074
SUPERVISOR
I REI v'A VIEW ON I REVIEW S LE I MANGROVE
REVIEWREVIEW
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