HomeMy WebLinkAboutBuilding permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ad Permit Number:
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.W Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT .. • FOR:
Address: 6564 Teresita Ct
Property Tax I D #- 1306-111-0001-000/0
Site Plan Name: Scoles, George
Project Name: Scoles
Install accordion shutters on concrete block home $ i
New Electrical Meter. Second Electrical Meter
Lot No.
Block No.
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: Sq. Ft. of First Floor:
Cost of Construction: $ S2J b6 •CJzS Utilities: —Sewer _Septic
Building Height:
OWNER/LE�SSE�E: �:
C®'NTR/�C�T®R:
Name Wynne Building Corp — scpJG J
Name: Lawrence V Cichanowici
Address:12804 SW 122nd Ave
Company:AMS Inc.
City. Miami, FI State: _
Address: 941 SW 8th St
Zip Code: 3318.6 . Fax:
City: Pompano Beach State: FI
Phone No.772-878-5513
Zip Code: 33069 Fax: 954-782=0995
E-Mail:
Phone No 800-226-6677
Fill in fee simple Title Holder on next page (if different
E-Mail maryannp@amsoffla:com
from the Owner listed- above) -
State or County License .CGC1505972 ...
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.
SUPPLEMENT L`CONSTRUCTION LIEN1LAW, 1NFORI,&V�I.A3�„TION
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DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name: James Bushouse Inc.
Name: n/a
Address:3300 NE 10th Ter #24
Address:
City: Pompano Beach
State: FI
City:
State:
Zip:33064 Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY:
Not Applicable
Name: nia
Name: nia
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.
-Signature lessee/Contractor Agent for Owner
Signature Contractor/License
a _wrier/ as
of er
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF St Lucie
COUNTY OF Broward
Sworn to (or affirmed) and subscribed before me of
Swo� to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
� Physical Presence or Online Notarization
t ' day of fn a44 2020 by
day of S 2020 by
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Dchan
Name of persdd making statement.
Nani_ep_fpersc;Jnaking statement.
Personally Known OR Produced Identification 66-1
Personally Known X OR Produced Identification
Type of Identification
Ty a of Identification
7PQd9ced
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{SignatuI4.1il?
(Signature of NotPPu S a y o FORM
My Commission GG 3=569
CommissiLOnE01`8505/06/2023 (Seal)
My Commission GG 322669
Commission No. ��: `=xpireso5l05/2( al)
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