HomeMy WebLinkAboutBuilding permit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Y L 0 ° ED) k Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:Temporary Power
PROPOSED IMPROVEMENT LOCATION:
Address: 4824 Watersong Way
Property Tax ID #: 2532-500-0051-000-7
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Temporary power pole
New Electrical Meter X Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit– check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing _Sprinklers Generator
Total Sq. Ft of Construction:
Cost of Construction: $ 600
Sq. Ft. of First Floor:
9
Lot No. 37
Block No.
Windows/Doors Pond
Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name rl'i r
Name:John Gazdacko
Address: X56 l
Company:JGE: II inc
City: 4 State: f7t
Zip Code: y of Fax:
Phone No.
Address:2126 sw azure ave
City: port saint iucie State: FL
Zip Code: 34953 Fax:
Phone No772-528-2129
E -Mail:
Fill in fee simple Title Holder on next page [ if different
from the Owner listed above)
E -Mail yourelectric@hotmail.com
State or County License31148
va�uc vULPtIaUuLew11 130 cauU ur more, a Kr-LUKUtU IYorice Or Lommencement 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: T Not Applicable
Name:
Address:
BONDING COMPANY: Not Applicable
Name:
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
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 attorney before commencing work or recording vnur Nntira of (-nrnmanr omont
ad
Signature of Owner/ L see/Contractor as Agent for Owner
Signature o Contract /License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF_S-� LueA p-
COUNTY OF _ L
Swc�n to (or affirmed) and subscribed before me of
Swo to (or affirmed) and subscribed before me of
,/ Physical Prese a or Online Notarization
this -7 day `�� I�
Physical Presen or Online Notarization
"-7
of 2020 by
this day of I\ 2020 by
Name of person making statement.
Name of person making tatement.
Personally Known O Pro ce I enti i a.i
sonally Known r
Natary Public Ste e�pT-Tor�da
Type of Identification Brian R SchaferMY
T e of Identificatio �'"
of Florided
Commission GG 308842
Expires 03/05/2023
7N.tate
P ce ..er
GG 308842
n
023
(Sigiaature o ary Public- State of Florida)
(Signal ublic- State of Florida }
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED