HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
�� V�
Date: 1i29i2020 Permit Number:
7
0
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 X
nL....... /9901 Ac9_, CC1 Cnv. 17771 AC7-1❑7R CnmmPreial Residential
PERMITTVPE: Residential Remodel
�jji�� n r�yA� y� CIYIc-�ITt.o�T►ol� " ,h {n..a '
Address: 7259 South Indian River Or Fort Pierce 1•I 349t5Z
Property Tax ID #: 3507-332-0002-000-9
Site Plan Name: Gale Residence
Project Name: Gale Residence
Lot No.
Block No.
Remove existing trusses and roof, interior of home to be remodeled. A front porch and & patio to be added
and make home into a 4 bed 3.5 bath.
Additional work to be performed under this
ypermit -check all that apply:
IlLiviechanical _Gas Tank G=Gas Piping _Shutters I Windows/Doors'
Electric Plumbing _Sprinklers _Generatov Roof 6/12 Pitch
Total Sq. Ft of Construction: 5182 Sq ft Sq. Ft. of First Floor.:' 8� 38 sq ft
156,000.00 Utilities: Sewer Septic Building Height: 20 feet
Cost of Construction: $ —
li� j Nrn
prr>ss'cTRar
NameDerrick Gale
1 art a��
i d fi y j5,p k�'6 },4� ..,,.}
..�....,,��,Wa
Name: Derrick Gale
Address:7259 S Indian River Dr
Company: Gale Construction, Inca ,
Address: 7259 S Indian River
City: Fort Pierce State: _
City: Fort Pierce State:_,'
Zip Code: 34982 Fax:
Phone No.561-248-9939
E-Mail:Demckgale@galeconstruction.com
Zip Code: 34982 Fax
Phone No561-248-9939
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail Derrickgale@galeconstructon.com
State or County LicenseCGC-060706
if value of construction is szsou or more, a newnutU rvaa.ce v.w......C....c...v....o.cy.•..-_•
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEWLAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: RichardBoyeae
MORTGAGE COMPANY: _Not Applicable
Name:
Address:4031 Coconut Blvd.
Address:
City: Royal Palm Beach State: FI
Zip: 33411 Phone 561-790-5766
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ 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,
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 YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE Of COMMENCEMENT."
C )
�\ CA &
Signat of Owner/ Lessee/coniTactor as Agent for Owner
Signa of Co ractor/License Holder
STATE OF FLORIDA
SAI't i- �C
STATE OF FLORIDA
S�•1�..;.A.
COUNTY OF -,L_
COUNTY OF
The fQ rgoing instrument was acknowledged before me
Tq"day
The forgpoing inst ment was acknowledged before me
this of &^O 20 20 by
thisci`'t day of 20M
�p11SUJ• k . � 4 Q
by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification X
Personally Knn-5Wn - OR Produced Identification
Type of Identification i
Type of Identification
Prod ced a T
Produced
5hPr�•7�>e..
( gnature of Notary Public -State of Florida)
(1gnature of Notary Pub ic- to of Florida)
Commission No. 6161300(,O j (Se I.II ShantO R.IFLORICA
aeMRWdssion No. (Seal)
NOTARYUBLIC
A,
"in
9:STJ E
� o d 2
REVIEWS
FRONT
= CommS
ZONING E E�i( Q§
G300608
1Ig
VEGETATION
SEATURTLE
m O3 o y
COUNTER
REVIEW REVIEW
REVIEW
REVIEW
REVIEW
mli-" I
DATE
rn o ' " W
0o
RECEIVED
c
DATE
,tijD 0)< T
COMPLETED
"vim
Kev. Z///19
AMR q ShantO R. Jackson
o<NOTARY PUBLIC
COmmk GG300608
Expires 2/11/2023