HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED G1 n `/.q
Date: Permit Number:c dt yo 17 0
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462=1578 Commercial Residential
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 2403 River Hammock Ln,Fort Pierce,FL 34981
Property Tax ID#.3404-313-0011-040-2 Lot No.
Site Plan Name: Block No.
Project Name: Carol Costas
DETAILED DESCRIPTION OF WORK:
Install Hurricane Protection Products on(1)opening
"CONSTRUCTIONINFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank —Gas Piping VShutters _Windows/Doors
VElectric —Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction: $5319.00 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
NameCarol Costas Name:Noreen E.Rayner
Address:2403 River Hammock Ln Company:Storm Smart of Southeast Florida
City: Fort Pierce State:FL Address:4047 Okeechobee Blvd,STE 106
Zip Code: 34981 Fax: City:West Palm Beach State:FL
Phone No. Zip Code: 33409 Fax: 884-330-8277
E-Mail: Phone No 561-229-0048
Fill in fee simple Title Holder on next page{if different E-Mail
from the Owner listed above) State or County License CfzC 132'I
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
5UPPLEMENTALCONSTRUCTION LIEN LAW [NFORMATIOty:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Add ress:
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 certifythat no work or installation has commenced priorto the issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize the permit holderto build the subject structure
-which is in conflict with-any-applicable Horne Owners Association rules;bylaws or and'covenantsthat-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 YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR"NOTICE OF COMMENCEMENT.w
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Signature of Owner/Lessee/Contractor as Agent for Owner Sig ature of Contractor cense Holder
STATE OF FLQRIDA STATE OF FLOPI A
COUNTY OF f C�G COUNTY OF
The forgoing instrument was acknowledged before me The forg i g instrument was acknowledged before me
this -7 day of DC iF ---,20� by thistlayof — 2020 by
CGt,Yd lC OSS S __�o(ezri, — ---------
Name of person making statement. Name of person making stateiiment.
Personally Known —OR Produced Identification V_ Personally Known_J —OR Produced Identification---
Type of Iden ifi Type of Identification
Produced L ----- Prod _
(SignatONo.
f o ry i -Pu S< f 0"91? {Sig ature of otary Public-State of F rids.
NOTARY PUBLIC d7.7ar�a,.
-- $'STfMPFFLORIDA
Commis Commission No. .m=
6 31�4�a ?Comm#GG317472 -- -- � �,,
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REVIEWS FRONT ZONING , `SUPERVISOR PLANS VEGETATION SEA T�I J F,ZgMdR .
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEVO'ii t Rl6w
DATE
RECEIVED `
DATE
COMPLETED
Rev.