HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ,, II
Date: Permit Number: Q1nn 1 0 4— Q f l(Q
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
PERMITTYPE: Wood deck
PROPOSED IMPROVEMENTIOCATION:4820Southwihdtrail,
,
Address: 4820 Southwind trail
Property Tax ID #: 4
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Wood deck 12- fj IS
CONSTRUCTION INFORMATION: -
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: 224 Sq Sq. Ft. of First Floor:
Cost of Construction: $ 975.00 Utilities: —Sewer —Septic
Lot No.
Block No.
Windows/Doors
Roof Pitch
Building Height:
OWNERAESSEE
CONTRACTOR:
Name Joseph W Fersch
Name: SAME Owner Builder
Address:4820 Southwind Trail
Company:
City: Ft. Pierce State: _
Zip Code: 34951 Fax:
Phone No. 772-473-1410
Address:
City: State:_
Zip Code: Fax:
Phone No
E-Mail:jtfersch@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
State or County License
If value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice bf Commencement is required.
LIN
SUPPLEMENTAL CONSTRUCTION LIEWLAW INFORMATION'-,
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
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 coNict 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."
Signatu� er/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA 1
STATE OF FLORIDA
COUNTY OF , .
COUNTY OF
They�§§[r�. oing inst umentw s acknowledged before me
The forgoing instrument was acknowledged before me
thisJ6 dayof.1 20tqby
this day of 20_ by
Name of person1makingstatement.
Name of person making statement.
Personally Known ✓/ OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
1
Produced
(Signature of Notary Public -State of Florida
(Signature of Notary Public -State of Florida )
Commission No MEN S(SMIELSEN
,state of Florida -Notary Public
- mission 0 GG 207484
Commission No. (Seal)
REVIEWS
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REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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