HomeMy WebLinkAboutBuilding Permit ApplicationIIAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED a;
Date: Permit Number: a�002 `
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 x
PERMIT TYPE:
PROPOSED IMPROVEMENTLOCATION:
Address: 5701 Buchanan DR Fort Pierce, FL 34982-3253
Property Tax ID #: 3402-603-0005-000-9
Site Plan Name:
,,
Project Name:
DETAILED DESCRIPTION OF WORK:
Replacing with Impact windows —
Lot No.
Block No. -
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
ab
Cost of Construction: $J — Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Robert Dumont
Name:
Address:5701 Buchanan DR
Company:
Address:
City: Fort Pierce, FL State: _
Zip Code: 34982 Fax:
Phone No. ?723706308
E-Mail: bdumont63@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
City: State:
Zip Code: Fax:
Phone No
E-Mail
State or County License
IIt value of construction is SZ500 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: -
DESIGNER/ENGINEER: X_ Not Applicable
Name:
Address:
City: 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, 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 LEPPER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. "
Siggeure of Owner/ ee/ContractoT—a!Agent for Owner
STATE OF FLORI A
COUNTY OF�.��✓
The wfor�oing instrument was acknowledged before me
this "1�1 day of 20W by
Name BT person making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced
1Ap Karen Des
&"dn NOT F
(Signature of Notary Publi - ate of FloriclfflSTATE OF
Comm# G
Commission No.GG0%53D (Se Expires 3
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this day of , 20_ by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
berg
'UBLIC
FOWAire of Notary Public- State of Florida )
1085301
2gW21ssion No. (Sea])
PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW