HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:0 Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential (Gc4�✓"�
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: & 9 a AIGM-1t-h(li'rA H.
U
Property Tax ID #: J'OG 5- b - 0-3 7 `( - OD U - $ Lot No. 4
Site Plan Name: nLLlcl,ty --Wn6w�sS C Block No. 7q��
Project Name:
DETAILED DESCRIPTION OF WORK:
GtM�uc Sln;nSi<� fe lncil &cgt,� i�Sku Inew �;p-G�.P u,�d�+l;yrr t
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New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
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 Roof Pitch
Total Sq. Ft of Construction: � 6 a a Sq. Ft. of First Floor:
Cost of Construction: $ �� I ( Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name: �IrSi ZGl sin��✓I
Name tG1oYY 4S E
Address (s Cc ./i lzm Lh �vs S>
Company: ah dF Co✓rJt e vJp S
City; �(Xr+ 1 r trca State:
Address: 0
City: Ut&-6 UJ 4C4� State I-L
Zip Code: 3acl:I Fax:
Phone No.
Zip Code: 3a4 (o 4- Fax:
E-Mail:
Phone No �—?'a" d31 $7 55
Fill in fee simple Title Holder on next page ( if different
E-Mail . i i I ( B pRn dw 6N14v4 c#ekr , (O n
State or County License I n c r- , r, 0,yw
from the Owner listed above)
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:
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City:
Zip: Phone
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Address:
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 your Notice of Commencement.
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORID
STATE OF FLORIDA
COUNTYOF I418u� 10X-t+'
COUNTYOF JjJJJAr< kWcr
Sw rn (or affirmed) and subscribed before me of
S rn to (or affirmed) and subscribed before me of
P ysical Pres ce or Online Notarization
this day of ui 2020 by
hysical Preserf1C e or Online Notarization
this � day of .. 14 iT 2020 by
1t
_ J ill IZ .�Frn
Jitt Ic. S4h 6'vS
Name of person making slat ment.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Prod ILL 2 L
Produced
(Ejolikdre of Notary aPhI�LIC
(so ature of Not -_- a 1
STATE OF FLORIDA
Commission No. °L.n.
PUBLIC
Commission S'YATEOFFLC,� ,)
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No. .n.
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REVIEWS
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SUPERVISOR
PLANS
VEGETATION
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COUNTER
REVIEW
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Certified GAF Master Elite and Gulf Coast Roofing Contractor
Member of the Certified Contractors Network
PREFERRED OPTIONS
INVESTMENT
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Financing Options
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Deposit Amount:
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Payment Option:
SCSP -
Balance Due at
Job Completion:
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YOU, THE OWNER MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT
OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE THE
NOTICE OF CANCELLATION CLAUSE BELOW FOR AN EXPLANATION OF THIS RIGHT.
ACCEPTED AND AGREED: The prices, specifications and conditions contained herein this Agreement are satisfactory and hereby
accepted. You are authorized to perform the work as specified.
(MUST BE SIGNED.BY AL�L,PVVNERS)
OWNER: i>.— >"-�— OWNER:
DATE: 6 C
AGREEMENT IS NQyi FULLY EXECUTED UNTIL SIGNED BY A SALES PROFESSIONAL THAT IS CURRENTLY EMPLOYED BY
PANDA CONTRACTORS INC. AND THIS AGRREMENT IS APPROVED BY PANDA CONTRACTORS, INC. MANAGEMENT.
DATE: z L 2 (✓I
We at Panda Contractors would like to thank you in advance for this opportunity to review and prepare this proposal for your home. We
are totally committed to providing "Complete Customer Satisfaction" before, during and after your roofing project. We have taken
pains to make sure this proposal is suited to meet your needs for now and in the future. Please call me at your convenience if you have
any questions at all. We look forward to working with you.
Yours truly,
smf- Sefrgaraa
Sergio Zeligman, President
Panda Contractors, Inc.
Panda Roof
State License CGC 006984, CCC 1331821
Telephone 772-231-5959 • Fax 866-711-0251
www.nandaroof.com Prepared For: Dutcher