HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Ia712 l�o� Permit Number:
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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: Donald Coburn
PROPOSED IMPROVEMENT LOCATION:
Address: 1404 Hartman Road Fart Pierce, FL 34947
Property Tax ID q: 2417-233-0002-020-2 Lot No.
Site Plan Name: Donald Coburn Block No.
Project Name: Donald Coburn
DETAILED DESCRIPTION OF WORK:
RE-Roof:Shingle 2 Standing Seam Metal
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 4 Pitch
Total Sq.Ft of Construction: 1830 Sq.Ft.of First Floor:
Cost of Construction:$ 16.200 Utilities: -Sewer —Septic Building Height: 12'
OWNERAESSEE: CONTRACTOR:
NameDonald Coburn Name:Anthony S.Bono
Address.1404 Hartman Road Company:Borgzinner Inc
City: Fort Pierce State:FL Address:1160 W. 13th Street
Zip Code: 34947 Fax: City: Riviera Beach State:FL
Phone No.561-848-3402 Zip Code: 33404 Fax:
E-Mail:noemail@gmail.com Phone N0561-848-3402
Fill in fee simple Title Holder on next page(if different E-Mail Tony@borgzinner.com
from the Owner listed above) State or County License CCC 1332224
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: Not Applicable MORTGAGE COMPANY: 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 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,l do hereby agree that l 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.
L cie County and posted on the jobsite before the first inspection.If you intend to obtain financing,consult
h lender or an attorney before commencing work or Mcording your Notice of Commencement.
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Sjfifre of /Lessee/Contractor as Agent for Owner ign of Co actor/License Holder
STATE OF FLORIDA STAT F FLORIDA
COUNTY OF-1— COUNTY OFPa-Bewh
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
x Physical Presence or Online Notarization x Physical Presence or Online Notarization
this — day of.hM=n�j 2020 by this tau, day of nL-g=ax r ,2020 by
Anthony S.8°no Anth°rry S Bono
Name of person making statement. Name of person making statement.
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
Produced Produced
M111JAY R:�=
(Sign ture of Notary lic-State of Florida) (Signs re of Notary Public-State of Florida J
Commission No ST p1iANIE YENS Commission N PNANIEL. 5
MY COMMISSION 9 GG 910270 ,. :.: MY COMMISSION p GG 9i0270
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COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
iev.5/6/20