HomeMy WebLinkAboutBuilding Permit Application (2) ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: I
MAAR0o.
P1 4.
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
PERMIT APPLICATION FOR: Window/door =j
PROPOSED'IMPROVEMENT LOCATION:
Address: 6404 Oleander Ave.Port Pierce,Ft 34982
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Legal Description: 10 36 40 S 1/2 OF N 1/2 OF N 1/2 OF SW 114 OF SW 114-LESS W 33 FT(13A)(4.95 AC)(OR 3754-472)
Properly Tax lD#: 3410-331-0002-000.9 Lot No.
Siite Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Window Replacement
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[CONSTRUCTION INFORMATION:
Aciclitional work to be nerformedunder this permit—c ec a appy:
j [1HVAC u Gas Tank [D..piping _Shutters 1— 1 Windows/Doors
Electric Plumbing Sprinklers E Generator 11 Roof Roof pitch
Total Sq.Ft of Construction: S . Ft of First Floor-
Cost
loorCost of Construction:$ 8,000 Utilities.. Sewer Rseptic Building Height:
01MNERJLESSEE 'CONTRACTOR
Name Steven Holden Name:
Address: 6404 Oleander Ave. Company:
City: Fort Pierce State:FL Address:
Zip Code: 34982 Fax: City. State:
Phone No. 610'462'5051 Zip Code: Fax:
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E-Mail: Phone No.
Fill in feesimple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License:
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 pians,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 usesto 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.
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Signature of Owner/Lessee/Contractor as Agent for Ovines Signature of Contractor/License Rider
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 'Z� COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this��day of 'Mn,.. .20 by this day of 20 by
Name of person making statement Name of person making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced F� Produced
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(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Commission No. ;•,r��;;, �SeSa�) Commission No. (Seal)
rt AHNA INGFiAM .
C
-4 06'. Notary Public-State of Florida
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DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17