HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8/14/2020 Permit Number: % 08
O
AUG 19 2020
- Building Permit Application
.Planning and Development Services, ST., Lucie County, Permitting
Building and Code Regulation Division Commercial XXX Residential
2300 Virginia Avenue, Fort Pierce FL. 34982 . .
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR-,
.O a C o yv\
PROPOSED IMPROVEMENT LOCATION:
Address: 2007 Totten Rd, Fort Pierce, FL
2417-332-0014-000-7
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name: Moonswiners
F,6tUI DESCRIPTION':OF W-ORK:..
to repair roof due to tree falling and causing damage
New Electrical Meter Second Electrical Meter
CONSTRUCTION I_NFORMATION:
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 xx:.Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 5,000 utilities:. Sewer _Septic Building Height:.
'OWN'ER%LES'SEE.CONTRACTOR:
=.
Name Danny E Adkins Cheryl C Adkins
Name: Michael Jacquin
Com panY; Paul Jacquin &Sons, Inc
Address: 9821 Orange Ave Fort Pierce, FL 34945
City: Fort Pierce Stater_
Address: 7348 Commercial Circle
Zip Code: 34945 Fax:
City: Fort. Pierce . State: FL .
Phone No. 772-464-6766
Zip Code: 34951 Fax: 772-466-2806
E-Mail:
Phone No 772-465-2475
Fill in fee simple Title Holder on next page (if different.:
E-Mail michael.jacquin@pjsi.com
State or County License CGC060473
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:
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 :i.n the public'records of St.'
Lucie County and posted on the.jobsite before the first inspection. If you intend to obtain financing, consult
with lend n attorneybefore commencin work or recordingr o tice of Commencement.
Ali
SllPPL'EMENTAL CONSTRUCTfON ;LIEN LAIN INF,ORMATION;
DESIGNER/ENGINEER:
Name: Architectonic
Not Applicable
MORTGAGE COMPANY::
Name:
Not Applicable
Address: sos Delaware Avenue
Address:
City:
Zip:.. Phone:
State:
City: Fort Pierce State: F�
Zip: 34950 Phone 772-460-7751
FEE SIMPLE TITLE HOLDER:
Name:
Address:
Not Applicable'
BONDING COMPANY:
Name:
Not Applicable
Address: •
City:
City:
Zip: Phone:
Zip: Phone:
Signature o r essee/Contractor as Agent for Owner
Signature
icense Holder,STATE
OF FLORASTATE
7oftr
Rj�lCOUNTY
OFCOON
�_ -} \��� � (� �•q
Sworn to (or affirmed) and subscribed before me of
N
Swo� to (or affirmed) and subscribed before me of .
P yslcal Presce. Online Notarization
this p�
day `A\) 2020 by
P yslcal Pres nce r Online Notarization
day of 2020 by
of
.this
Name of person making statement.
Name of person'making tatement.
Personally Known N/ OR Produced Identification
Personally Known OR Produced Identification
Type of Identificatio
Type of Identification
Produced C
Pr du e
(Signat e o otar Public- a orl
� Puy o ry Public State of Florid
n ure of. oar Pu c State o on a
( Y V ler
Nikki Cutler
Commission No. i � ($��mmission GG 189140
iovA C.
� .:. � My Commission GG 189140
C mission No. �orao� Expire3��/��'2022 "
?oFFs�op Expires 02/22/2022
11
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