HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
{. t
5 -
� D
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
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION: (�
Address: 1216 NW Winters Creek Rd,Palm City,FL 34990
Property Tax ID#:4423-701-0013-000-7 Lot No.
Site Plan Name: Block No.
Project Name: James Pierson
DETAILED DESCRIPTION OF WORK:
Install Hurricane Protection Products on(4)openings
CONSTRUCTION INFORMATION:
Add itio na I wo rk to be performed under this permit–check a 11 that apply:
_Mechanical _Gas Tank _Gas Piping XShutters _Windows/Doors
XElectric —Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$22140.00 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
NameJames Pierson Name:Brian Rist
Address:1216 NW Winters Creek Rd Company:Storm Smart Building Systems
City: Palm City State:FL Address:6182 Idlewild St
Zip Code: 34990 Fax: City:Fort Myers State:FL
Phone No. Zip Code: 33966 Fax: 884-330-8277
E-Mail: Phone No 561-229-0048
Fill in fee simple Title Halder on next page(if different E-MailSHale@StormSmartSE.com
from the Owner listed above) State or County License CRC056857
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN?LAW 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:
Ad d cess: 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 certifythat no work or installation has commenced priorto the issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize the permit holderto build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenantsthat 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 exemptfrom undergoing a full concurrency review: room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to anoth non-residential use
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF ME CEMENT RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTIC OF C&IMENC T MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTIO IF YO INTEND O AIN FlNANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDIN YOUR N TICE O M ENCEMENT.
SignatuZFLORIDA
Owner/Lessee/Contractor as Agent for Owner 'g ature of Contra or/Lic se Holder
STATEG STATE OF COUNTY OFFLORIDA C
COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of [AA�19,--,2020 by this L day of 4 1 LA,&L . ,2020 by
J a u S Pl e r_Corl I —1hn �- ecs--- --
Name of person making statement. Name of person making statement.
Personally Known_ OR Produced Identification Personally Known_—L/—OR Produced Identification —
Type of Identificatio Type of Identification
Produced Produced
611"AlSs Yesenia Sarzuela —
a�' o�NOTARY PUBLIC
2STATE OF FLORIDA
l� , YE3@fttt��8filfEl
{Signature of o' Public-Stat d {Signat a of ary Pu is-State of F
CE 1 xpires 3/28/2023 o,NOTARY PUBLIC
Commission No. 6(031�'�2 (Seal) Commission No. Co I��_1A�2 g a. STATE OF FLOR D
Comm#k GG3174 2
S�vCE is Expires 3/28/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.