HomeMy WebLinkAboutbuilding permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6 —1 2-0 Permit Number:
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 FOR:
PROPOSED IMPROVEMENT LOCATION:
Residential YES V
Address: 2704 S 29TH ST :E�gA_T ;ACC
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name: WILLIAM HOPKINS
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors _ Pond
Electric Plumbing Sprinklers _ Generator oof jZ Pitch
Total Sq. Ft of Construction:# ZS Sq. Ft. of First Floor:
Cost of Construction: $5 Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name WILLIAM HOPKINS
Name: EDWARD LECHNER
Address:2704 S 29TH ST
Company:EDIFICIUM CONST
City: FORT PIERCE State:
Zip Code: 34981 Fax:
Phone No.
Address:1215 CASTAWAY BLVD
City: VE:RO BEACH State: FL
Zip Code: 32963 Fax:
Phone No 772-643-4513
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail edificiumroofing@gmail.com
State or County License CCC1 331308
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 LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
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:
Zi p: 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an att ne before commencing work or recording Notice of Commencement.
Signature of Owner/ Lesse6OUntractor as Agent for Owner
Signature of Cont`?'tor/License Holder
STATE OF FLORIDA 4
COUNTYOF ,� � -�Z.—l.tr�L�
STATE OF FLORIDA
COUNTY OF +1 �; ,� Ucy,
5w rn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of tF 20220` by
Swor -to (or affirmed) and subscribed before me of
f./ Physical Presence or Online Notarization
this ((c- day of
f
�27020(by
Name of person making statement.
Name of person making statement.
Personally Known/ OR Produced Identification
Personally Known `/ OR Produced Identification
Type of Identification
Type of Identification
ProdujcedlI
Produced
p
(signature of ota��rAblic�ateis�fdkorida)
T NOTARY PUBLIC
Commission No — ., E OF FLC
Comm* GG971143
(Signature of Notary P,4j�� StaWafftrdda )
_Amp 0 NOTARY PUBLIC
Commission No_ �STAT! OF I�I0A
w; a Comm# GG971143
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