HomeMy WebLinkAboutBuilding Permit Application :-ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Building Permit Application
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie- County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: VVindow/door
PROPOSED IMPROVEMENT LOCATION:,
Address: 6803 DICKINSON TERR., PORT ST LUCIE
Legal Description: OLEANDER PINE REPLAT BLK 1 LOT 132(0.343 AC) (OR 759-304)
Property Tax ID#: 3415-706-0003-000-1 Lot No. 132
Site Plan Name: /11)/A Block No. 1
Project Name: JAMESON PROJECT
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION QF'
\WORK: p
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CONSTRUCTION INFORMATION:
Additional work toe performed under this permit-check all appy:
11HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
FlElectric ❑Plumbing ❑Sprinklers Generator Roof Roof pitch
Total Sq.Ft of Construction: ' S Ft.of First Floor:
Cost of Construction:$ 9500 Utilities0-Sewer[]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name SHARON JAMESON Name: JOHN JACOBS
Address:6803 DICKINSON TERR Company: JOHN JACOBS CONSTRUCTION INC.
City: PORT ST LUCIE State:FL Address: 4701 OLEANDER AVE.
Zip Code: 34952 Fax: City: FORT PIERCE State:FL
Phone No.772-882-8334 Zip Code: 34982 Fax: 772-466-6491
E-Mail: Phone No. 772-882-8334
Fill in fee simple Title Holder on next page(if different E-Mail: JMJACOBS4701 @GMAIL.COM
from the Owner listed above) State or County License: CBC060421
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.
Signatur f Owner Les Contractor as Agent for Owner Signatur of Contractor/ ' ense Hol
STATE ORIS+ , bAc. Q- COUNTYOF
STAT F _ 1
COUNTYOF -1.4 C, Q-
The forging instrument was acknowledged before me The forging instrument was acknowledged before me
this da of sr c 2018 b this � day of A us+ 20 19' by
JpV,,n JACO 6'r --So -;SA&6r
Name of person making statement Name of person making statement
Personally Known _OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature otary Publi Signature of NdFary Public-State of FkwiAa
CASEY BINKLEY ASEY BINKL
Commission No. FF238333 :., t,.; 1l,, ommission No. FF238333 = '' SS
tvAe WISSION q FF23 �1G UOMMISSION#FF 3 M.
EXPIRES August 16,2910 ''3 d�;'~ EXPIRES At" sl 16, 0
'i' . i.+r$Ibi ` 401) 9ts•a;•^ Slav ,Nita.�aAwiS®'
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17