HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort pierce FL 34982
Phone: (772) 452-1553 Fax: (772) 452-1578
Permit Number:
Building permit Application
Commercial Residential xx
PERMIT TYPE: temporary power pole
PROPOSED IMPROVEMENT LOCATION:
Address: 4924 Watersong Way, Ft. Pierce, FL
Property Tax ID #: 2532-500-0073-000/7 Lot No. -_59- .
Site Plan Name:
Project Name: Thompson residence
DETAILED DESCRIPTION OF WORK:
Install temporary power pole
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
Block No.
_Mechanical — Gas Tank Gas Piping _ Shutters _ Windows/Doors
Alectric ` Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ gtJO
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Michael and Kathy Thompson
Name: Larry B Stamper
Address: 722 Holly Lane
Company: Powercom, LLC
City: Arnold, MD State: _
Address: 2511 NW 16th La. #8
Zip Code: 21012 Fax:
City: Pompano Beach State: FL
Phone No.
Zip Code: 33064 Fax: 954.978.1440
E-Mail:
Phone No 954.978.7070
Fill in fee simple Title Holder on next page ( if different
E-Mail Istamper@powercomllc.com
from the Owner listed above)
State or County License 31093
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: I
DESIGNER/ENGINEER: x Not Applicable
Name: _
Address:
Ity:.---- ------ ----- — -- -State:
Zip: Phone — ----------
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address: - -
--------- - --
City: State:
Zip: _.. - --- - -- Phone: — -
BONDING COMPANY: =Not Applicable
Name:
Address: _
City:- -- - - - --
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, 1 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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Sign t of &7 Lessee/C ntractor a Agent for Owner ;
SignatiGe of Co o ractor/Licensh Holder
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SA-h OF FLORIDA
STATE OF FLORICAA7
COUNTY OF
COUNTY OF Pirb I:ekLrd_,
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The forgoing instrum�ent as acknowledged before me
this%� day of �/ 20� by
The forgoing instrument was acknowledged before me
this �J day of .Id/e/ 20LQ by '
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Name of.person/aking sta rr ent.
Name of person making statement.
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Personally Known ,. OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
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Produced
Produced
(Signature of Notary Public- State yi Florida)
(Signature of Nota ublic- State of Florida�)^"�
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September 23, 2019
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VEGETATION
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MANGROVE
COUNTER
REVIEW
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DATE
RECEIVED
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Rev. Z///19
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