HomeMy WebLinkAboutReed Building Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
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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:dwq/ d C. (►eed
PROPOSED IMPRQV NT;L0C4T1Ot ;
Address: 3/k0 1-;4 d0. kisfa At -c. Jrv,4- Pie.ct fL 3VfB2
Property Tax lD #: Z'YZ dr —1901 —600-000-9 Lot No. / S
Site Plan Name:
Project Name:
Block No. A
Name (sOWdrd C.. Kee <3
Address: 31 KO Linda vis+a
City: For-(" T � Ie/c2 State: F�
ZipCode:.3441f2- Fax:
Phone No. 77 2 -q1 U - 4(1 (p
E -Mail: wcc dvn-f, a (c,�fle viorrwYemerts .ne P
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: Dv(aG LarC-
Company:TOtal R#01,n S llem-S
Address:31yo 56 aale� _S1
city: Sf'va-" 4" Stater
Zip Code: 34 q 1 7 Fax:
Phone No 772 -y10 - 9//v
E -Mail ACco
State or County
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:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
COUNTY OF (lull^
Address:
Swor to (or affirmed) and subscribed before me of
City:
Zip: Phone
State: T
City:
Zip: Phone:
State: _
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
-.-.—Not Applicable
Address:
Name of person making sta ement.
Personally Known OR Produced Identification_
Address:
Type of Identification
City:
Produced
City:
A
(Signature of Notary Pf bli - State of
Zip: Phone:
(�G`�yUi .'`a.*•�` SHERESAJFFE
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Zip: Phone:
Commission No. Notary
OWNER CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
1 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 attornev before commencing work or recording your Notice of Commencement.
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ignature of Own Lessee Co tractor as'Agent for Ow
of nse Hoi
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF (lull^
COUNTY OF 110.✓'F I r_\
Swor to (or affirmed) and subscribed before me of
swo o (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
V Physical Presence or Online Notarization
_
this zOrdayof 0 f'B 2020 by
this LTt%ay of 0rt D -0T, .2020 by
reed
DL/ife
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Name of person making sta ement.
Personally Known OR Produced Identification_
, Name of person making st ent
Personally Known OR Produced identification
Type of Identification
Type of Identification r
Produced
Produced
A
(Signature of Notary Pf bli - State of
S1 nature of No a k FE
(�G`�yUi .'`a.*•�` SHERESAJFFE
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Commission No. Notary
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202301 ''.' aFf My Comni. Expires Apr 1, 2022
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