HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED � /5
Date: �` - U Permit Number: y/ y ��
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: To Select from dropbox, click arrow at the end of line V-
PROPOSED IMPROVEMENT LOCATION:
Address: 7903 WESTMONT DR.
Legal Description: LAKEWOOD PARK-UNIT 3-BLK 22 LOT 26(MAP 13/115)(OR 4034-194)(7903 WESTMONT DR)
Property Tax ID#: 1301-603-0171-000-7 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
n 64,:_J t c 1 1� C C oRt l o n rj e 25'
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CONSTRUCTION INFORMATION:
Additional work toe performed under this permit.-check all appy:
HVAC Gas Tank Gas Piping _Shutters Windows/Doors
❑Electric ❑ Plumbing Sprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: Sq Ft. of First Floor:
r
Cost of Construction:$ I Fr 7S`� Utilities: U_Sewer[]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name EDWARD MENTZ Name: MATTHEW MARKS
Address:7903 WESTMONT DR. Company: EAST COAST ALUMINUM PRODUCTS INC
City: FORT PIERCE State:Fl_ Address: 913 EDWARDS RD
Zip Code: 34951 Fax: City: FORT PIERCE State:FL
Phone No.708-803-6890 Zip Code: 34982 Fax: 772-464-7603
E-Mail: Phone No. 772-464-7600
Fill in fee simple Title Holder on next page ( if different E-Mail:
from the Owner listed above) State or County License: 24526
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.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF—.S T. 1.t4eit COUNTY OF ST Luc i E
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this_,;o day of ,7&i. , 201 by this 31:;'44, of .T**rJL4A 04 201,.e by
AA779Efa A4AF_XX 1%TroeN /yeI2kS
Name of person king statement Name of person king statement
Personally Known VOR Produced Identification Personally Known ZOR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of otarµ�,P l c tato ®r ,�kLMAN (Signature of f d
to '
" "" DONALD M.NOL N
r• n: Notary Public-I�tatB of Florida akar n��,�
Commission ommissionA 113240 Commission N .:+ o: Not Public•A=
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My Comm.Expires Sep 20,2019 ;� Commission#F FF 91324
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA T'U RT L OVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17