HomeMy WebLinkAboutBuilding Permit Application All 4PPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: AUG.14,2020 Permit Number:
RECE1VED
AUG 19 020
• IR I ' Building Permit Applicatio ST. Lucie County, Permitting
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR:
PROPOSED]MP ROVE M ENT LOCATION:
Address: 5407 EASTWOOD DR. FORT PIERCE FL. 34951
Property Tax ID#: 1301-614-0007-000-1 Lot No.6/7
Site Plan Name: LAKEWOOD PARK UNIT12 Block No. 157
Project Name: MICHAEL NEWSOME
DETA'ILEDrD�ESCRIPTI®N'bF;'WOR
' Y a
NEW ROOF 5V METAL
New Electrical Meter Second Electrical Meter
CON STRUCTI'ONI N'FORMATI'O N:
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 5/12 Pitch
Total Sq. Ft of Construction: 3200 Sq. Ft.of First Floor:
Cost of Construction:$ 17000.00 Utilities: _Sewer _Septic Building Height:OWNER/LESSEE-CONTRACTOR:
Name MICHAEL NEWSOME Name:JOHN G.CANNON
Address:5407 EASTWOOD DR Company:JOHN G CANNON
City: FORT PIERCE. FL State:_ Address:7901 CITRUS PARK BLVD
Zip Code: 34951 Fax: City: FORT PIERCE State:FL
Phone No. Zip Code: 34951 'Fax: 772-468-0272
E-Mail: Phone No 772-468-0202
Fill in fee simple Title Holder on next page(if different E-Mail JGCANNONROOF9ICLOUD.COM
from the Owner listed above) State or County License CCC1330664
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.
a
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:
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 Counter 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,wails,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 our Notice of Commencement.
6Signe of Owner/Lessee/Contractor as Agent for Owner Sign ture of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 5 k. l+0 c COUNTY OF G-V, l•Je
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization Physical Presence or Online Notarization
this\q day of 2020 by this VN day of 6,6s 2020 by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced identification
Type of Identification Type of Identification
Produced Produced F'"X- 6
(Signature of Nota ublic-State of Florida) (Signature of Notap,P oN#"G G
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