HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number: oosu
OnflUTCELE . VN
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address: 1544 NW Buftonbush Circle
Property Tax ID #: 4426-815-0054-000-5
Site Plan Name: Harbour Ridge -Plat 13-Buftonbush Village Unit 47
Project Name:
Lot No.
Block No.
9
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Electrical Meter Second Electrical Meter
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:
Cost of Construction: $ 7356.11
NameJohn & Cynthia.Lpry.ibardo,
Address: 1544 NW Buttonbu'sh"Or6l'
City: Palm City
State.
Zip 34990
Code:
Phone No. 305-794-5595
E-Mail:johnpct@me.com
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name:Chris.gers ,R
. P '. ,
Company: C9asta 1, - P.1 u hi b in'g' ."S e'r_vi'c"es,,-, !'.r-') c.
Address:27f SW-L'akbhu'r's't:br".".';'.,-
City: Port Saintt Lucie - state: FL
Zip Code: 34983 Fax:
Phone N0772-940-1144
E-Mail timnelson8l @gmail.com
State or County License CFC#1 428462
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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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 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 our Notice of Commencement.
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Sign ture of Ow / Lessee/Contractor as Agent for Owner
Signature of Contra r/License Holder
STATE OF FLORIDA f
STATE OF FLORID I
COUNTY OF
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
V Physical Presence or Online Notarization
i/ Physical Presence or Online Notarization
this of 2020 by
this Z day of —✓ 2020 by
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C�viS Q6ci,
Name of person making statement.
Name of person maki g statement.
Personally Known OR Produced Identification
Personally Known X OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced II --��
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(Signature t
(S ida )
,eV Notary Public State of Florida
Commissio o TRACYCARVALHO((Sea])
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Expires 03/22/2024
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