HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPR D FOR APPLICATION TO BE ACCEPTED
Date: 11-17-2020 Permit Number:
1�lro d�jIC�IlL
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial - Residential XXX
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:Steven W and Tammy Rogers
:PROPOSED IMPROVEMENT LOCATION:5307 Hickory Dr, Fort Pierce
Address: 5258 Academy Rd, Cookeville,TN 38506
Property Tax ID#: 3402-608-0436-000-4 Lot No.42
Site Plan Name: Indian River Estates-Unit 07 Block No. 51
Project Name: Demolish Pool and deck
DETAILED DESCRIPTION OF WORK:
Demolish fiberglass pool and surrounding concrete deck
New Electrical Meter NIA 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 Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 2,400.00 Utilities: —Sewer —Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name Steven W and Tammy Rogers Name:John Creswell
Address: 5258 Academy Road Company:Green Design Construction and Development, LLC
City: Cookeville State:_ Address:4459 SE Kubin Ave I
Zip Code: 38506 Fax: City: Stuart State:FL
Phone No. 931-252-1494 Zip Code: 34997 Fax:
E-Mail: tkrswr@gmail.com Phone No 772-210-6814
Fill in fee simple Title Holder on next page(if different E-Mail John@gdcflorida.com
from the Owner listed above) State or County License CGC1516250 j
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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SUPPLEMENTAL CONSTRUCTION.LIEN LAW INFORMATION,
DESIGNER/ENGINEER: _Not Applicable MORTGAGE 1.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/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,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 attorney before commencing work or recording our Notice of Commencement.
Signature of Owner/Lessee/Contracto as Agent fo wn_eor Signature of ntractor Licens716r
STATE OF FLORID STA OF FLORIDA
COUNTY OF - . LLL6 eJ COUNTY OF�� �
Swo n to(or affirmed)and subscribed before me of Swoon to(or affirmed)and subscribed before me of
Physical Pres rice or Online Notarization V Physical Presence or Online Notarization
this Q»day of 110jember 2020 by this 3 day of JD(3: l"(l� 2020 by
mn=r-1 EA�cx
Name of person making statement. Name of persah making statement.
Personally Known V' OR Produ&c#,1 �ntrficai��°''�, Personally Known OR Produced Identification
Type of Identification 2 Type of Identification
Produced =V OF .G'__ Produced
TENNESSEE
NOTARY
(Signature of Notary Public-State i la) Q.`;� . (Signat a of Notary Public- _ kW4ry Public-State of Flo id
..•..•I:. = ebrnmission N{GG 9733,19
Commission No. �(��a�pY��} t,��'��'"``���\ Commission No. `1 �` q. a_pmmission Expire
11 ( March 25, 2024
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED I
DATE
COMPLETED
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