HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
91To
O
P 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 APPLICATION FOR: Robert L Johnson
PROPOSED IMPROVEMENT LOCATION:
Address: 4706 El Nueva Avenue Ft Pierce, FL 34946
Property Tax ID#: 1431-703-0025-000-6 Lot No. 3 &4
Site Plan Name: HARMONY HEIGHTS ADDN NO 3 BLK B W 1/2 OF LOT 3 AND ALL LOT 4 Block No. B
Project Name: 6653 Johnson
DETAILED DESCRIPTION OF WORK:
Replace windows and doors
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 X Windows/Doors _ Pond
Electric Plumbing _Sprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor: 990
Cost of Construction: $ 8500.00 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Robert L Johnson Name:James W Foster
Address:4706 El Nueva Avenue Company: Patriot Response Group
City: Ft Pierce State: FL Address:2770 Indian River Blvd Suite 501
Zip Code: 34946 Fax: City: Vero Beach State: FL
Phone No. (772) 577-6465 Zip Code: 32960 Fax:
E-Mail:estiajohnson@yahoo.com Phone No 850-603-9451
Fill in fee simple Title Holder on next page(if different E-Mail permitting@patriotrg.com
from the Owner listed above) State or County License CGC-1526178
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Nat Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
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/CO—NTRACTORAFFIDVIT: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,waits,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 recordi ,ngy our Notice of Commencement.
S7ig_nature of Con—tractor/4" nse Helder
Signature of Owner/Lessee/contractor as Agent for Owner
STATE OF FLr%n STATE OF FLORIDA
COUNTY OF GI 'Lth 4, COUNTY OF—Okaloosa
Skorn to(or affirmed.)and subscribed before me of Sworn to for affirmed)and subscribed before me of
Physical P rW,!eor_unine Notarization Physical Presence or Online Notarization
Z�
this day of 0 2020 by 4thday of Dkc�en��2020 by
_Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Ide 'fica!tr' Type of Identification
IN
Produced
(Signature of Notary ul,l F;-, �'Fi
(Signature of Notary Public- )CAROL A PORT
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Commission Nod) 'on LI
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0, Bonded Through NdP Expires 08130/2024
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COMPLETED
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