HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date : 10/22/2020 Permit Number:
tfto dUCE �.
' Building Permit Application
Planning and Development Services
e
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 :
PROPOSED IMPROVEMENT LOCATION :
Address : 8200 Fort Walton Ave, Fort Pierce, FI 34951
Property Tax ID #: 1301 -606-0073-000-9 Lot No. 1
Site Plan Name : Block No. 61
Project Name: David Ogden �s " oo {-us 3 U1 Ve
DETAILED DESCRIPTION OF WORK: °
Replace 20 windows YCN aor
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION :
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:
u
Cost of Construction: $ Z I % 2 Li O Utilities: _ Sewer _ Septic Building Height:
OWN.�R/LESSEE : CONTRACTOR :
Name LVk% A npeyA Name: e icor. c
Addres/s:' 2Q6 h } 1 n1A140n Iy" T- Company: 6t, �9 oc5
City: ?U plCrC>` State: F/ Address:
Zip Code: 3 N QS I Fax: City: hli-Of) Q) Stater./
Phone No. >5� Zip Code: u 2 tog Fax: 9W -7 ML 1 ' S 3 3
E-Mail : e� Phone o 1 - 13Z - 030 v
Fill in fee simple Idle Holder on next page ( if different E-Mail C 44+FQoo C ts l� Atm �c6yy '
from the Owner listed above) State or County License < (-( 3 )f � 04 7
If value of construction is 25M or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,SOo or more, a RECORDED Notice of Commencement is required.
I
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION ' Not Applicable
— Not Applicable MORTGAGE COMPANY: _
DESIGNER/ENGINEER: — Name :
Address : State:
Address:_ State : _ City :
City : Phone Zlp .
Phone : , I
Zip : _-- Not Applicable
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY:
Name :
Name: - � Address:
Address: City: Phone:
City: Phone:
Zip: and installation as indicated.
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work
I certify that no work or installation has commenced prlar to the issuance of a permit.
licable Home Owners Association rules, bylaws or and covenants that may restrict a prohibit such
St Lucie County makes no representation that is granting a permit will authorize the permit holder [o build the subject structure
which is in conflict with any app erform the work
structure. Please consul[ with your Home Ow�mers Association and review your deed for any restrictions which may apply.
In consideration of the ranting othis r
equested permit, Ig o hereby.agree that I will, in en men
in accordance with the approved plans, the Florida Buildin codes and St Lucie County Am review: room additions,
The following building permit applications are exempt from undergoing a full concurrenty
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 of St.
improvements to your property. A Notice of Commencement must be recorded in the public recordsconsult
irst
Lucie
with lender ain
County
ran attor aosted ttorneyn the before commencing the
work orlrecording IourNo ice of Comu intend to mencement.
Signature of Owner/ Lessee/ ctor as A Contragent for Owner Si� of Contractor/L�se Holder ',i
STATE OF FLORIDA STATE OF FLORIDA P ��
COUNTY OF COUNTY OF
Sworn to for affirmed) and sub3e66ed before me of Sworn to of-affirmed) and subscribed before me of
Physiral Presence or Online Notarization % ysical Presence or _ Online Notarization
this 2ti day of 10 2020 by this Z2�day of � y 2020 'by
!)o� d )G ta
Name of person making tement Name of person making statement
Personally Known OR Pr d Identification Personally Known OR atificatlon
Type entification Type of Identifiwtiun
Produ Y OMeFRfk
^: �fr E fp �Missr dfq?iF
nature of Notary Public- State o rRFg, rgyy c ature of Notary Public- State of Florida ryga ?o s�sa
Yoh
Commission No, (Seal) �(, o� mission No. all �
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE t
COMPLETED I --