HomeMy WebLinkAboutBuiding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 22 June 2020' Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (M) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION: J
Address- 761 Cypress Street
Property Tax ID #: 3419-501-0085-000-2 Lot No. 14
Site Plan Name: Block No. 8
Project Name-,
DETAILED DESCRIPTION OF WORK:
Replace 9X7 Garage Door
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be per-formed under this permit – check all that apply:
—Mechanical Gas-Tank —Gas Piping Shutters Windows/Doors Pond
Electric Plumbing Sprinklers Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: S 500 Utilities: Sewer Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Audrey Sharland
Name: Evan Weilage
Address: 761 Cypress Street
Company: Coastal Garage Door
City: Pt St Lucie State:
Zip Code: 34952 Fax:
Phone No.--
Address: 601 SW Hillsboro Circle
City: Pt St Lucie State: FL
Zip Code: 34953 Fax:
Phone No 772-812-7023
E-Mail:
Fill in fee simple Title Holder on next page if different
from the Owner listed above)
E-Mail ecoastaldoors@aol,com
State or County License 27238
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:
DESIGNERJENGINEER. 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 thepermit 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
wit nder or an attorney before commencingwork or recording our Ngtice of mmencement.
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signature of Owner/t�e'' e/Contractor as Agent for Owner
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Signa ure of Co tractor/Li se Holder
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Sw9m to (or affirmed) and subscribed before me of
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5vyr to (or affirmed) and subscribed before me of
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Ph y ical Presence or Online Notarization
Physical Presence or Online Notarization
thisay of 2020 by
this day of _ 2020 by
Name of person making statement. m N
Name of person making statement.
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Commission No. 1 (Seal)
Commission No.66 !��/� (Seal)
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