HomeMy WebLinkAboutpemit applicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
COtI NT Y
F D R
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
Address: 7508 COQUINA AVE
Legal Description: LAKEWOOD PARK -UNIT 7- BLK 79 LOTS (MAP 13/02N) (OR 3997-2170)
Property Tax ID #: 1301-607-0226-000-0
Site Plan Name: HFH Coquina
Project Name: HFH Coquina
Setbacks Front Back: Right Side: Left Side:
11 DETAILED DESCRIPTION OF WORK:
TUG meter install
Lot No. 5
Block No. 79
CONSTRUCTION INFORMATION:
Additional work to M
r Orme un er t is permit –c ec a appy:
HVAC Gas Tank E]Gas Piping _ Shutters a Windows/Doors
ZElectric ❑ Plumbing Sprinklers 11 Generator F]Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $
S Ft. of First Floor:
Utilities. — Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name St Lucie Habitat For Humanity Inc
Name: Donald B Green
Address: 702 S 6th ST
Company: Don Green Electric
City: Fort Plerce State: FL
Zip Code: 34950 Fax:
Phone No.
Address: 1305 W 1st Street `
City: Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone No. 772-418-5739
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: dongreenelectric@gmail.com
State or County License: EC13007447
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable
Name:
MORTGAGE COMPANY: X Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:
BONDING COMPANY: X Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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 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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording vour Notice of Commencement.
t,,-aJJ
of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License HoTffer
STATE OF FLORIDAt�,� STATE OF FLORIDA
{ .
COUNTY OF , gs COUNTY OF H'kjgn I\f
Th Forging instrument was acknowledged before me
thiay of 26}4by
(Signa reU Notary Public- State of Florida )
Personally Known xxxxx OR Produced Identification
Type of Identification Prod
Commission No.
Revised 07/15/2014
JOY CHRISTINE UUMLANu
MY qm SION #FF948042
EXPIRE : JAN 05, 2020
Bonded through 1st State Insurance
The forgoing instrument was acknowledged before me
this 4th day of cam _ 20 F+ by
Personally Known xxxxxx OR Produced Identification
Type of Identification Produced
Commission No. "", JOY C ECOPELANO
MY COMMISSION #FF948042
1st State Insurance
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