HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 06/30/2020 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone. (772) 462-1SS3 Fax: (772) 462-1S78
PERMIT APPLICATION FOR: ROOF
PROPOSED IMPROVEMENT LOCATION:
Address: 10720 Orange Avenue, Fort Pierce, FL 34945
Property Tax ID #: 2309-144-0001-000-4
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Tear off shingles and replace with metal
New Electrical Meter Second Electrical Meter
I CONSTRUCTION INFORMATION:
Residential X
Lot No._
Block No.
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 X1 Roof 4/12 Pitch
Total Sq. Ft of Construction: 6000 Sq. Ft. of First Floor:
Cost of Construction: $ 26,000 Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Wendy Hamilton
_�—
Address: 10720 Orange Avenue
Name:
Company:
City: Fort Pierce State:
Zip Code: 34945 Fax:
Phone No. 772-216-4500
Address:
City: State:
Zip Code: Fax:
Phone No
E-Mail: hamiltonws@gmail.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail
State or County License
n vaFu vF L.uFIaLI YL.LFuII Fb CJVV OF more, a ncLumitu ivorice or 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:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 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,
accessary 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 retarded 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 attorney before commencing work or recording our Notice of Commencement.
t
4�jL� n:� J
Signature of Own er7 lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of��V C1L� 2020 by
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of 2020 by
( -
Name of person maki g statement.
Name of person making statement.
Personally Known OR Produced Identification `4—
Type of Identificat
Produce V-C_ <
Lauren Mats
moo' State of Florida
=z ireS 0612E
(Signature of Notary Publ' Sta% °' a )CommissionNo.GG117
�� OF f� \\
ii.4
Personally Known OR Produced Identification
Type of Identification
Produced
021
(Signature of Notary Public- State of Florida)
Commission No. i5 (Sea[)
Commission No. _ (Seal)
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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