HomeMy WebLinkAboutSigned and Noterized PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8.24.20 Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fart Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Matthew Blake
PROPOSED IMPROVEMENT LOCATION:
Address: 7505 Coquina Ave Fort Pierce FL 34951
Property Tax ID #: 1301-607-0101-000-8 Lot No.24 & 25
Site Plan Name: Lakewood park unit 7 blk 73 wl 112 of lot 24 and all of lot 25 Block No. 73
Project Name: Matthew Blake Windows
DETAILED DESCRIPTION OF WORK:
Installation of 2 impact windows and one mull bar
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 i Shutters X Windows/Doors Pond
— Electric _ Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 2,000.00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Matthew Blake Name:Ryan Mills
Address:7505 Coquina Ave Company -Trenton King Inc
City: Fort Pierce State: � L Address:2332 SE Jackson St
Zip Code: 34951 Fax: City: Stuat State: FL
Phone No. Zip Code: 34997 Fax:
E-Mail: Phone No561-307-8493
Fill in fee simple Title Holder on next page I if different E-Mail Trentonkinginc@aol.com
from the Owner listed above) State or County License CGC1528078
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: _ Not Applicable
Name:
Addre!
City: _
Zip:
Phone
State
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:_
Address:
City:
Zip:
Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:_
Address:
City:
Zip: Phone.
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 Horne 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 atto,Fney before commencing work or recording your Notice of Commencement.
as Agent for Owner
STATE OF FLORIDA
COUNTY OF ST- Cam[ 6- C
Sworn to (or affirmed) and subscribed before rile of
Physical Presence or Online Notarization
this' ? day of 2020 by
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Name of person making statement
Personally Known K OR Produced Identification
Type of Identification
Produced
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DATE
RECEIVED
DATE
COMPLETED
Signature o Contra r/License Holder
STATE Ol`FLO A
COUNTY
Sworn to (or affirmed) and subscribed before me of
_,%C_ Physical Presence or Online Notarization
this _Z+day of A1JVS:r— ; 2020 by
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Nam of person making statement.
Personally Known _?�_ OR Produced Identification
Type of Identification
Produced
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