HomeMy WebLinkAboutupdated permit applicaitonAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6/4/2020
Permit Number: 2005-0401
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION F!' OPEN Arr.r
p a p p r k
Address: 4960 Conley PI, Ft Pierce FI 34951
Property Tax ID #: 1313-131-0007-000-6
Site Plan Name:
Project Name:
Residential x
Lot No.
Block No.
Installation of 48'x 36' open carport on 1.02 acre home site in the county. Cost of the building was $5,500 and owner/builder. The buidling has
been installed.
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: 1,728
Cost of Construction: $ 0
Generator Roof Pitch
Sq. Ft. of First Floor: 1,728
Utilities: —Sewer —Septic Building Height: 17
NameJoseph Branca
Address:4960 Conley PI
City: Ft. Pierce FL State: _
Zip Code: 34951 Fax:
Phone No.772-370-1910
E-Mail:jbranca@brancarealty.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name:
Company:
Address:
City: State:
Zip Code: Fax:
Phone No
E-Mail
State or County License
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEU LAW INFORMATION
DESIGNER/ENGINEER: _ Not Applicable
Name: Gregory S Hurd
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:15710 Peruvian Lily Ct
Address:
City: Brooksville FL State:
Zip:34604 Phone727-492-5986
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
Zip: Phone:
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 paying twice for
improvemen s o y r property. A Notice of Commencement must be recorded in the public records of St.
Lucie Count a d o ed on the jobsite before the first inspection. If you intend to obtain financing, consult
with lende or n t me before commencingwork or recordingour Notice of Commencement.
(/V)
Signature of O / L ee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF RI
COUNTY na,C..n71 L y% :
STATE OF FLORIDA
COUNTY OF
SworVto (or affirmed) and subscribed before me of
Physical Prese ce or Online Notarization
this day of 2020 by
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of 2020 by
Name of pe son making statement.
�OR
Name of person making statement.
Personally Known Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
P e
Produced
JAMIE
tONNOR
(Sign re of Notary Public- State of Flori Notary m Public
My Comm. E
Commission No. � ea()"""'goaded through Nat
- 5 Notary Public- State of Florida }
res Feb 27, 2024
oli*Rffi#AAiQ) o• (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
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SEA TURTLE
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REVIEW
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DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20
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