HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: \QAr# 11 Permit Number: 0 Val- G
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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
PERMIT APPLICATION FOR: Alteration
PROPOSED IMPROVEMENT LOCATION:
Address: 7904 Kenwood Rd. Fort Pierce, FL. 34951
Legal Description: l
Property Tax ID#: 1301-605-0239-000-8 Lot No.7
Site Plan Name: Block No. 49
Project Name: lafitalliAg
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
�3i;pt 5�n,4om-f_ 1tibolor SKyV,gk-
CONSTRUCTION INFORMATION:
Additional work toe nerformed under this permit-check a appy:
❑HVAC Gas Tank []Gas Piping _Shutters ❑Windows/Doors
11 Electric E] PlumbingSprinklers ❑Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 1329.00 Utilities: L]Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Bryan Porter Name: James E. Reynolds
Address:7904 Kenwood Rd. Company: Corad, Inc.
City: Fort Pierce State: FL Address: P.O. Box 5900
Zip Code: 34951 Fax: City: Lake Worth State:FL
Phone No.772-359-4344 Zip Code: 33466 Fax: 561-439-2196
E-Mail: Phone No. 561-439-2184
Fill in fee simple Title Holder on next page ( if different E-Mail: sunny@theskylightcontractor.com
from the Owner listed above) State or County License: CGC 054348
If value of construction is$2500 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: 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 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 our Notice of Commencement.
gnature of Own /Lessee/Contractor as Agent for Owner nature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA J �,�,
COUNTY OF__>�/Q�/r1h COUNTY OF G /[
The f r oing instrument was acknowledged before me The f r oing instr����ppen)was ckno edged efore me
this day of /VO 11�/ &,r 12017 by thisco day of 91 t/V Q 20/�by
Ji4vn es E_ �� P,.,uo id y/d S
Name of person making sdatement Name of person making statem t
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced by-Iyer'S L.ICQIysx Produced icents-e
'7Pie?
(Sign re of Notary Public-State of Florida) (Signa re of Notary Public-State of Florida )
Commission No. GG Commission No. ,
#V by Notary Public State of Florida 4111` No�e'y pWnic State of Florida
% Regina Catherine Bradford ` P4 'tib Cythenne Bradford
My Commission GG 160961 My .++?Flji11✓ii 6(1�f�11tl941
aExpires 1111W021 wEU21
REVIEWS FRO PLANS VEGETATION SEA TU L
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17