HomeMy WebLinkAboutpermit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Permit Number:
Building Permit Application
Commercial Residential
Address: 355 PALMS AVE, FORT PIERCE, FL 34982
Property Tax ID #: 3403-501-0154-000-8 Lot No.
Site Plan Name: Block No.
Project Name: WILLIAM & PATRICIA RODGERS
DETAILED DESCRIPTION OF WORK:
6 Windows & 1 Door
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical
_ Electric
Gas Tank
_Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 15,250
—Gas Piping
_ Sprinklers
_Shutters
_ Generator
Sq. Ft. of First Floor:
Windows/Doors
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name WILLIAM & PATRICIA RODGERS
Name: DAN BECKNER
Address:355 PALMS AVE
Company: PARADISE EXTERIORS LLC
City: FORT PIERCE State: FL
Zip Code: 34982 Fax:
Phone No.772-240-5710
Address: 1918 CORPORATE DR
City: BOYNTON BEACH State:FL
Zip Code: 33426 Fax:
Phone No 561-732-0300
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mailparadiseexteriorsllc@gmail.com
State or County License SCC131150472
If value of construction Is $2500 or more, a RECORDED Notice of Commencement is requires.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
_Not Applicabre
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
COUNTY OF_-------�--_
Address:
The for ding instrument was acknowledged before me
this day of2019 by
City:
Zip: Phone
State:
City:
Zip: Phone,
State:
FEE SIMPLE TITLE HOLDER:
Name:
_Not Applicable
BONDING COMP ANY:
Name:
_Not Applicable
Address,
Type ofIdentification �u D. No
Address:
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City:
City:
Zip: Phone:
(Signature otary Public -State of Florida)
Zip: Phone:
Commission No. — (Seal)
OWNER/ CONTRACTORAFFIDVIT: 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 Count ,makes no representation that Is granting a permit will authorize the permit holder to build the subject structure
which is in uri%ct with any, applicable Home Owners Association rules, bylaws or and covenants may restrictorprohibit 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 YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
p0 THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
iH YOUR D OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
x:2/7/19
ignatureofOwner Le ee 1° or sAgentforOwner
Signature of Contractor/LicenseHolder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF�f, I A I aI G
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this day of2019 by
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'eo, •,a.`° EXPIRES: April 10, 2022
(Si ature of Notary Public -State o FOmm tnden
(Signature otary Public -State of Florida)
Commission No.
Commission No. — (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
x:2/7/19