HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 0114120w Permit Number: VOI V�
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
RECEIVp
Building Permit Application .IAN 2 8 2020
ST. Lucie County, Permitting
Commercial Residential
PERMITTYPE: EIZG{YiC
PROP 05ED;IMPROUEMENT LOCATION;
Address: 7803 Lakeside Way Fort Pierce, FL 34951
Property Tax ID #: 1301-603-0137-000-7 Lot No.20 T2
Site Plan Name: Block No. Z)
Project Name: %W CLrrt �ac,a r.
CONSTRUCTION INFORMRTION n
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ qcl 1000
_ Generator _ Roof Pitch
Sq. Ft. of First Floor: 2 1 l¢0 i
Utilities: _Sewer _Septic Building Height:
J,WA" (LESSEE:: ;.7 _ :,;. :m,
CONTRACTOR: z
Name William Fagan
Name: Phlip Tzl�n '%llF
Address: 7803 Lakeside Way Fort Pierce, FL 34951
Company: IRWLh E12eivic- A Cpntm l FLI Inc•
City: Fort Pierce State: FL
Zip Code: R4g51 Fax:
Phone No. b-iA6ici - 2`i(e7
Address: 7b aLt i no nr" Lv�
City: orlmaO State: F L.
Zip Code: 32$001 Fax: A
PhoneNoiLAU'1> - %5-i-1979
E-Mail:WiI1T0, qM il.GOM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail o� eirmi Wtog (o� aH ccheloc� ri r . co r�+
—-
State or County LicenTse EC 13U01 to R a
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.
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DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
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
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Signature o Owner[ see/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF '!I -
STATE 6F FLORIDA ��
COUNTY OF
The for oing instrur� ent was acknowledged before me The forgoing instrument was acknowledged before me
this R day of_ ^ 20QQ by this 2`i day of [/wry 20,;10 by
Name of person mak g statement. Name of persmaking statement.
Personally Known OR Produced Identification Personally Known n OR Produced Identification
Type of Identification , Type of Identification
I
�Isrgnature of Notary b �,, to y1foW1>3Q&� Stem of Florida
gnature of Nota -
[ �"
Jason M OAermiIler
�r0 �
Notary Public State of Florae
Commission No, x
My Cortngp�pn GG 3W338
023
Commission No. -
Jason M OtRnil r
yCammiw66dd 338
eT�
Expees Oa
114 M1
Expires 08/08/2023
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW -
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
u_IlLq
LMTED POWER OF ATTORNEY
Date:
I, Philip D. Bailey , do hereby name and appoint:
1:f�C:CTVCCJ -
JAN 2 8 2020
ST. Lucie County, Permitting
an agent of (Name of Company) Altech Electric of
Central Florida Inc. to be my lawful attorney -in -fact to act for me to apply for, receipt for,
sign for and do all things necessary to this appointment for this specific permit and application
for work located at:
7pD3 Lakes'; L 'ror, �g, �21 , 34q!1
(Street Address of Job)
License Holder Name: Philip. D. Bailey
State License Number: E 1682
Signature of License Holder: '
State of Florida
County of Orange
The foregoing instrument was acknowledged before me this 9,q day of jol� 20 24� ,
by Phillip D. Bailey who is personally known to me and who did (did not) take an oath.
Obermiller, Notary Public
�.Mr�W. NoteryPUN=MateofFh W
K Jason M obermiller
+a'« ^ g My C,_", on GG 38433E
�i d° E�Prtes owosn 23