HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /� O
Date: a Permit Number: vrly �V 3
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Permit ApplicationLAUG pp 0 2f320
Planning and Development ServicesBuilding and Code Regulation Division Commercial Residenty, Perm
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR (S
RROPOSED IMPROVEMENT LOCATI�ON� � ¢�� t � � �� � �`� d � t
Address: 7273 S Indian River Dr Fort Pierce FI 34982
Property Tax I D #: 3507-332-0003-000-6
Lot No.
Site Plan Name: Block No.
Project Name: King Residence
New Electrical Meter Second Electrical Meter V/
Additjonal work to be performed under this permit- check all that apply -
mechanical _ Gas Tank _ Gas Piping _ Shutters
Electric Plumbi fng _ Sprinklers _ Generator
Total Sq. Ft of Construction: 0 e
L Cost of Construction: $ 'W
"Windows/Doors _ Pond
Roof 5b 2- Pitch
Sq. Ft. of First Floor: LAGS
Utilities: —Sewer •� Septic
Building Height:
OWNER/LESSEE `�' ,d;" f* "ikf s4CONTRACI'OR
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a g ztt r r
Name l:nCe � L• Vim.
Name: errick Gale"
Company: Gale Construction, Inc.
Address:7259 S Indian River Dr
City:, Ft. Pierce State: Fl
Zip Code: 34982 Fax:
Phone No561-248-9939
Address: ^1�13 S Tv�di�4�il�iye� `Jt •
City: Fort Pierce State: PL.
Zip Code: 34982 Fax:
Phone No. ` i 2 — oZO I - ( 13 o
E-Mail: �S�a+P3 @ a--61--
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail Derrick@galeconstruction.com
State or County LicenseCGC-060706
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.
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SUPPLEMENTAL CONSTRUCrTI;ON LIfN LAW INFORMATION
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DESIGN ER/ENGINEER• _
Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: urn 0r;)e 4(:
_
Name:
Address: - G 31 Cocaou-r b)y cl
Address:
City: oucclw\, bza k
State: r— I--
City: State:
Zip: Phone TG 1 - 79
0-5 7 CC
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 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 attornev before commencing work or reciardina vour Notice of Commencement.
QA-w Y-L
Sign' re Owner/ Lessee/C ractor as Agent for Owner Signa ure of Contractor/License Holder
STATE OF FLORIDATATE OF FLOWA
� COUNTY OF ecc �-e_ I COUNTY OF J GLilr� V-V�_(_A
Sv(/rn to (or affirmed) and subscribed before me of
P ysical Presence or Online Notarization
this �I day of ( 2020 by
Name of perso . aking statemen
Personally Known � OR Produced Identification
Type of Identification
Sn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this � day o 2020 by
��n rr GEC l4 CA e_,
Name o person making statement.
Personally Known \/' OR Produced Identification
Type of Identification
ig f Notary Pu3 ; S< f Florida l3RITTANY HUFF Signatur oi(Vot*y Pubiic- Stat f ) BRITTANY HUM
;; MY COMMISSION # GG 970027 MY COMMISSION # GG
Commission No. ;"�• o= (51§51*ES: June 1, 2024 ommission No. al) EXPIRES June 1, 2
pdF °Q' Bonded Thru Notary Public Underwriters Bonded Thru Notary Public U
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED