HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 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 xxx
PERMIT TYPE:
Address: 12271 Golden Eagle St
Property Tax ID #: 4224-501-0011-000-8
Site Plan Name:
Project Name: Gregory T Davis
Replace Rheem 50 gallon Elec W/H
Additional work to be performed under this permit — check all that apply:
Mechanical _ Gas Tank —Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction:
Cost of Construction: $ 1275.10
Name Gregory T Davis
Address:12271 Golden Eagle St
City: Port St Lucie State:
Zip Code: 34987 Fax:
Phone No.954-647-6466
Sq. Ft. of First Floor: _
Utilities: —Sewer _Septic
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: Robert Barron
Lot No._
Block No.
Windows/Doors
Roof Pitch
Building Height:
Company: Lindstrom Air Conditioning
Address: 3501 W McNab Rd
City: Pompano Beach
Zip Code: 33069 Fax:
Phone No 772-600-4088
E-Mail dulcem@lindstromair.com
State or County License CFC142611
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.
State: FI
DESIGNER/ENGINEER: Not Applicable
Name:_
Address:
City:
Zip:
Phone
State
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:_
Address:
City:
Zip:
MORTGAGE COMPANY: _ Not Applicable
Name:_
Address:
City: _
Zip:
Phone:
State:
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, 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 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."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgoing instrument was acknowledged before me
The fo oing instrum nt was acknowledged before me
this day of 20� by
this q day of , 20j� by
Name of person making statement.
Name of person making statement.
Personally Known Xl� OR Produced Identification
Personally Known OR Produced Identification
Type of Identification �;`vat
Prod c d �pt•..°�. DULCEMARTINEZ
Type of Identification
P
Produced �a:nc� DULCEMARTINEZ
& * Co mission # GG 103391
mmission # GG 103391
"+ �� xplres May 10, 2021
j �; Expires May 10, 2021
a o� d ihrtt �udp�S Natery 9atW�e
Thm Mpt Notary 9orviGP
(Signature of Notary Public- StaotTforida)
(Signature of Notary Public- State of Flo 'Fa )
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19