HomeMy WebLinkAboutpermit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
C
- l . • J r.
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Permit Number:
Building Permit Application
Commercial Residential
Address: 6603 DELAND AVE, FORT PIERCE , FL 34951
Property Tax ID #: 1301-612-0334-000-6 Lot No,
Site Plan Name: Block No.
Project Name: WILLIAM & JEAN JUDD
DETAILED DESCRIPTION OF WORK:
2 Doors
CONSTRUCTION INFORMATION:
Additional work to be
performed underthispermit—check
all that apply:
_Mechanical
_Gas Tank
_Gas Piping
_Shutters
_Electric _Plumbing _Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 7,625
_Generator
Sq.First Floor:
Windows/Doors
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameWILLIAM & JEAN JUDD
Name: DAN BECKNER
Address: 6603 DELAND AVE
Company: PARADISE EXTERIORS LLC
City: FORT PIERCE State: FL
Zip Code: 34951 Fax:
Phone N0.772-5954845
Address:1918 CORPORATE DR
City: BOYNTON BEACH State:FL
Zip Code: 33426 Fax:
Phone No 561-732-0300
E-Mail:
Fill In fee simple Title Holder on next page ( If different
from the Owner listed above)
E-MaiG 'Mt}S•�r
State or County License SCC131150472
If value
of
construction is
$2500 or more, a RECORDED Notice of Commencement is required.
If value
of
HVAC 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: _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! nstallation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the ermit holde to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants tkat 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
OWARNINC TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH LENDER OR AN A ." ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT
)YOUR
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Signature of Owner/ Lessee/Contr r as Agent for wner
S' ture of Con cense Holder
STATE OF FLO,
COUNTY OF
STATE OF FLORIDA ------
COUNTYOF
The forgoing inst ument wa acknowledged before me
this'30 day of12CQMO(_, 20 uiby
The forgoing instrument was acknowledged before me
this Mclay of=g,, --� 20sX>y
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identifcation
Personally Known _� OR Produced Identification
Type of Iden "' ati n
Produced
Type of Identification
Produced___
Ae: %X'Solvpo�oos
(1(71 )A Ax M� N%
(Signature of Notary Public- e oil om o
HHObOj;Z �a�g°� ;onto'
Commission No. ° Ott 0 . "s
(ignature of Notary Public- ate of
s'• +�
Commission No.�yQ
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