HomeMy WebLinkAboutCCF_000459All APPLICABLE INFO MUST E COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/15/20 Permit Number:
Lul ul
Building Permit Application
Planning and Development Se ices
Commercial Residential x
Building and Code Regulation
ivision
2300 Virginia Avenue, Fort Pi
ce FL 34982
Phone: (772) 462-1553 Fa
: (772) 462-1578
PERMIT APPLICATION
FOR:JASON BROWN
PROPOSED IMPROVE
A ENT LOCATION:62020 EMERSON AVER
Address: 6202 EMERSON AVE
Property Tax ID #: 1301609C
D570000
Site Plan Name: LAKEWOO
PARK _
Project Name: BROWN
DETAILED DESCRIPTION
OF WORK:
REROOF WITH OC SHING
ES
New Electrical MeterJINF
Second Electrical Meter
Ne�
f CONSTRUCTIONRMATION
Lot No.13
Block No. 5
Additional work to be performed under this permit — check all that apply:
_Mechanical _ as Tank _ Gas Piping _ Shutters —Windows/Doors _ Pond
Electric PI mbing _ Sprinklers _ Generator _ Roof 4:12 2:12 Pitch
Total Sq. Ft of Construction 3900 Sq. Ft. of First Floor:
Cost of Construction: $ 16, 00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameJASON BROWN
Address:6202 EMERSO
City: FT PIERCE, FL
Zip Code:
Phone No.5203312817
E-Mail:
Fill in fee simple Title Ho
from the Owner listed above)
Name:NAKIA GELLER
AVE
Company: HIGHLAND HOMES
_ State: _
Fax:
Address:1136 US1
City: SEBASTIAN State: FL
Zip Code: 32958 Fax:
Phone No772-388-1411
der on next page ( if different
E-MailHHROOFING7@GMAIL.COM
State or County LicenseRC29027628
I
If value of construction is 25Pu or more, a KtI,VKvty rvoTIce yr k.urnFT1 r_W U111 n - —J.11—
If value of HAVC is $7,500 or ore, a RECORDED Notice of Commencement is required.
*�Fl6''dT^'XhJ�ITS
Sy?
1v7.,5
DESIGNER/ENGINEER:
Name:
Address:
City:
Zip: Phone
_ Not Applicable
MORTGAGE COMPANY: _
Name:
Address:
Not Applicable
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone
_ Not Applicable
BONDING COMPANY:
Name:
Address:
City:
Not Applicable
Zip: Phone:
OWNER/ CONTRACTOR
FIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
certify that no work or installz
Jon has commenced prior to the issuance of a permit.
St. Lucie County makes no repr
is in conflict with any ap
sentation that is granting a permit will authorize the permit holder to build the subject structure
licable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
which
structure. Please consult with
ur Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the grantin
of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approv
d plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit z
pplications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimmin
pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Yc
iur failure to Record a Notice of Commencement may result in paying twice for
A Notice of Commencement must be recorded in the public records of St.
improvements to you
Lucie County and post
property.
d on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender , ttt
ne efore mencin work or recordingtice of omme ent.
Signature df Owner/ Lessee/ ontractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORID STATE OF FLORID
COUNTY OF J.aJXM P►►W
S n to (or affirmed) and s bscribed before me of Sworn to (or affirmed) and subscribed before me of
Physical Pre ence or Online Notarization h sical Presence or Online Notarization
this day of 2020 by thi day of 2020 by
Name of person making sta
Personally Known
Type of Identification
Produced
(Silgnaturdbf Notary
Commission No.
REVIEWS FRONT
COUNTE
DATE
RECEIVED
DATE
COMPLETED
Name of person making statement.
Produced Identification Personally Known OR Produced Identification _
Type of Identification
Produc
at of I i re of N aryc•F ic W&F on a
��."•�• •y!t
l AH BALL ;, ' Commission HH Oq�79al)
ftemission # HH 007792 Commi Sion No. =� October
:i' 't: •.�f ors, OP:
A ao; Expires October 6, 2024 - 8ondad Thry Troy Fain Insurance 890-3857919
ZONING TSUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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