HomeMy WebLinkAboutBuilding PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description:
Property Tax ID #:
Site Plan Name:
Project Name: _
Setbacks Front
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Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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31 ilr4atw
TOS I
Lot No.
Block No.
CONSTRUCTION INFORMATION:
Additional work to be pertormed under this permit - check all = aprary:
oHVAC LJ Gas Tank Gas Piping nGenerator
Shutters Windows/Doors
Electric 0Plumbing Sprinklers Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ a,
00
Sq. Ft. of First Floor:
Utilities: Sewer Septic Building Height:
OWNERAP SEE:
CONTRACTOR:
Name (
Addr
r '�1A i1w%'IName:
r 7
Michael O'Donnell
Company: O'Donnell Impact Windows
City:
Zip Code:14 , T �
Phone No. ! ), "
_
State:
Fax:
—AC q5
Address: 1740 NW Federal Hwy
City: Stuart State; FL
Zip Code: 34994 Fax:
Phone No. 772-408-0200
E -Mail: odonnellpermitting@gmail.com
E -Mail:
Fill in fee simple Title Holder
from the Owner listed
on next page ( if different
above)
State or County License: CRC1331273
It value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: ` Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
N am e: Michael O'Donnell
Address:
Address:
City: State:
Zip: Phone
City: Stuart State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address: 1740 NW Federal Hwy
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
commencin work or recording our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner 6gnature of Contractor/License Holder T
STATE OF FLORIDA "I STATE OF FLORIDA
COUNTY OF �Al,-A �"4 \, COUNTY OF
The fo i g instr ent was ac owledged before me The f ing instr ent was acknowledged fore me
this day of y' 20 by this y of '° 20by
Name of person Ing statement Name of person ing statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced LI Produced
)/
(Signatur f Notary Public- State=ofa CsrWSUPERVIII
(Signat of Notary Public- State of Florida.)
P. P''' .1 Wt - WYNN ALLEN
Commission Nc ° f %ti ry Puborida Commission No.otary -State of Florida
ommis70 Commission # FF 923070
• a "'oFy Comm. 2019q,� ��°;My Comm. Expires Sep 30, 2019
hrn '��REVIEWS FRONT ZONINRVI OR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17