HomeMy WebLinkAboutBuilding permit appAll 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, Fart Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERM IT TYPE:
Cc, 5
Name —IC -4v o,,i f e•
Name: Blake Cowdell
PROPOSED IMPROVEMENT
LOCATION:
City: --82r4 54 GUS i e State,&_
Zip Code: j Fax:
Phone No.
Address: 3 c2
City: Port ST Lucie State: FL
Zip Code: 34984 Fax:
Phone No7727778133
/UXre�'l �. u, -
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Property Tax I D #:
f,
Y(
j O '. Gi C 0 " 6/,7
Lot No.
Site Plan Name:
GL+J�{'_
("a
Block No. �J J
Project Name:
DETAILED DESCRIPTION OF WORK:
Aboue-eroueidr I -e
a 5 It', � c 4 o ,
CONSTRUCTION INFORMATION:
Additional work to be performed under this per it – check all that apply:
Mechanical — Gas Tank \ Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ &l S Utilities: _ Sewer — Septic
Windows/Doors
Roof Pitch
Building Height:
WNER/LE
OSSEE;
CONTRACTOR:
Name —IC -4v o,,i f e•
Name: Blake Cowdell
Address: a' L!
Company: Energized Gas
City: --82r4 54 GUS i e State,&_
Zip Code: j Fax:
Phone No.
Address: 1786 SW Biltmore St
City: Port ST Lucie State: FL
Zip Code: 34984 Fax:
Phone No7727778133
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail en erg izedgenerators@gmail.com
State or County License LG34747
11 value ui wnscruczion is ;ic�uu or more, a KLCUKLMU 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: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
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.
1 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."
Signa? re of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLO
COUNTY OF ThA 2 u,
The Ding instr m nt was acknowledg before me
this ' day of ZO�y
Name of person makiFOR
ement.
Personally Known Produced Identification
Type of Identification
Produced
{Signature of
Signature of Contractor/License Holder
STATE OF FLORID
COUNTY OF
�St�
The f oing instru ent was cknowled d before me
this �p
y of 2oL by
Name of person making statement.
Personally Known ` ' OR Produced Identification
Type of Identification
Produced
{Signature
Commission
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DATE
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