HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11.23.2020 Permit Number: 67
RECEIVED
Co.NOV 2 3 2020
Building Permit Application Permitting Department
St. Lucie County
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: PREFAB SHED
PROPOSED,IM.PROVEMENT LOCATIO,N:'
Address: 3126 OLD EDWARDS ROAD, FORT PIERCE, FLORIDA 34981
Property Tax ID #: 2429-123-0001-300-1 Lot No.
293540 FROM NECOROFSW 114 OF NW 114 OF NE 114 RUN SOD DE317 MIN 20 SED W 282M Fr FOR PO%TH CONTS DO DS 317 MIN 20 SEC W 397.8 Fr, TH S SS DEG 52 MIN 70 SEC W
69b3 FTTO NELV RAV NSLWMD, TH NWLVALO SO NSLWMDR1W 29828 Fr. TH N22 DEO22 FAN13 SEC E254.78 FT, TH N 89 DE359 MIN 50 SEC E 201 F7TO PO&LESS E 15 FT FOR RD Rl Block No.
Site Plan Name: W-(1.91AC,(GR4126-144,
Project Name:
DEETAILED,DE$CRIPTION OF WORK:
PLACING PREFAB 32' x 12' SHED o p f % ,A Ug2R JAr-a A
("' mop of) wv :2Y4-V k
New Electrical Meter N/A Second Electrical Meter N/A
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: 384 SQ FEET Sq. Ft. of First Floor:
Cost of Construction: $ 9,100 Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE.
CONTRACTOR:
Name LANCE MILLS
Name:
Company:
Address:3126 OLD EDWARDS ROAD
Address:
City: FORT PIERCE, FL State: _
Zip Code: 34981 Fax:
City: State:
Phone No. 772.418.6723
Zip Code: Fax:
E-Mail: LPM3126@YAHOO.COM
Phone No
Fill in fee simple Title Holder on next page ( if different
E-Mail
from the Owner listed above)
State or County License
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.
.v
SUPPLEMENTAL CONSTRUCTION. LIEN LAW,INFORMATION ,.
DESIGNER/ENGINEER: X Not Applicable
MORTGAGE COMPANY: X Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
BONDING COMPANY: X 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 certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Count 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.
G
igoatur�i'16 Owr er e9seeJCohfraW65r as Agent for Owner
STATE OF FLORIDA `
COUNTY OF
Swr to (or affirmed) and subscribed before me of
sical Presence pr Online Notarization
this o day of.A) +1"V . 2020 by
.(,fince %-' )l.�
Name of person making statement.
OR Produced Identification
Type of Identifi a 'on
Produced -
(Signature of
V NYPUy�,, AUDREY B. HUMPHfztr
Commission No. =o<� ' '" "__ My COM(SNgN # GG 300817
tg. - EXPIRES: March 6, 2023
Fair d�4,' Bonded Thru Notary Public Underwriters
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of 2020 by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
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Rev. 5/6/20