HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ^/1I y� I
Date: 1 —�D_ Permit Number: t�too`/ -DysP
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMITTYPE:
PROPOSED IMPROVEMENT LOCATION:
Racelft
Building Permit Application
Commercial Residential
Address: 6514 Student Way Fort Pierce, FL 34951
Property Tax ID k: 1301-611-0097-00-9 Lot No.
Site Plan Name: carol bailey
Project Name: carol, bailey
Block No.
I DETAILED DESCRIPTIONOF WORK: I
foundation stabilize
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical
Electric
_ Gas Tank
_ Plumbing
Total Sq. Ft of Construction: _
Cost of Construction: $ 12600
_ Gas Piping
_ Sprinklers
_ Shutters
_ Generator
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic
_ Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Namecarol bailey
Name:Lawson walterjoseph
Address:6514 Student Way ,
Company:solid foundations
City: Fort Pierce State: _
Zip Code: 34951 Fax:
Phone No.7724656518
Address:2704 sw main blvd
City: lake city State:fl
Zip Code: 32025 Fax:
Phone N03867582727
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mailioe@solidfoundstions.com
State or County License cgc1526697
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:
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.
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."
cuA&6I Ax�= J
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF r G1(1,h 6Q
The forgoing instrument was acknowledged before me
The fo oing instrument was acknowledged before me
this _ day of 20_ by
this day of J4 /1 20— by
L cl,,;on
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Know OR Produced Identification
Type of Identification
Type of Identi (cation
Produced
Produced
(Signature of Notary Public- State of Florida)
(Signatur f goeary Public- State oa•., SHELLY PRUITrG
Commission No. (Seal)
.r.''
k Notary Aublic - Stat
Commission No.GG 3436y ) Commission # G
.,,,r ,.• My Comm. ExpiresA
•
Bunded through National'
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19
Pon-
MORTGAGE COMPANY:
Name:
_ Not Applicable
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY:
Name:
_Not Applicable
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.
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
1f//h
COUNTY OF
COUNTY OF C 6
The forgoing instrument was acknowledged before me
The for oing instrument was acknowledged before me
this LR,Iul 202%by
this7dayof L%4A 202oby
,.✓ 4 l lKx L6 wSet,
k'V kK b4404 .
Name of person making statement.
Name of person making statement.
Perso�Kw OR Produced Identification
Personall Know OR Produced Identification
Type n
Type o Identi nation
Produced
Produced
•SHFLi Y PRunrT nAymE
A
ignat of Notary Public -St F Rotary Public -State of Fl�I(Pniitur
f otary Public -State �..$KELLY PRUITTG
.tea Commission AGG 3287?°:Notary
•••.,,or i<,, fiComm. Expires Aug 18,
No.6 G _ "••^•�
duhllc • Stat
? Ij Commission # GCommission
ission No.6G ! 96- •..?hrough
JA
National Notarl
...r ,� My Comm. Expires A
••Bonded through National'
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.Z/I/19