HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
L�UQ C
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
'P"ROPOSEQ�C�PR01fEMENT
q�
� .. . .
Address:_ .
Property Tax.ID#: `F ) Lot No.
Site Plan Name: Block No.
Project Name:
'CtE-AILEQ QE-SCRIPT)OiV {}F°1lt10RK
77
New Electrical Meter Second Electrical Meter
CONSTRUCTION IN[=ORMATION
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 Constructions: t Sq.Ft. of First Floor:
Cost of Construction: $�� Utilities: _Sewer _Septic Building Height:
C3WNER/LESSEE. �� £ CONTRACT-OR� �� ,
a Y:.ffi � .,„��• ';t�P? ,f 3��,,.-. v.2P> F �K.dt�'a�,.7K-^
Name _ Name:Steven,C Mears
Address: jKl 00 company:Lifetime Exteriors .
City: State:_ Address:102 South F St
Zip Code: Fax:_ City; Lake Worth State:FI
Phone No. Zip Code: 33460 Fax: 561-582-7505
E-Mail: , one N0561-533-8700
Fill in fee si ple Title Holder on next page(if different E-Mail Diane@Lifetimeexte(ors.net
from the Owner listed above) State or County License CGC1529442
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.
Sl1PPLEMENTALCONSTRU"CTION.LIEN,LAW INFflRMATlfll l
DESIGNER/ENGINEER: _Not Applicable . MORTGAGE COMPANY. Not Applicable
—. Pp
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.
rX � .
Sig'Natuire of Owner Lessee/Contractor as or Owner Signature of Contractor/Li ense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 496rh JaCd COUNTY OF ?,¢ro7!` sW
�wprn to(or affirmed)and subscribed before me of 5w rn to(or affirmed)and subscribed before me of
'*A, P ysical Presenize or Online Notarization PbAical Presence or Online Notarization
this day of /V 2020 by this1# day of%,V,iVk,4lW 2020 by
10 1/1- y I '37alg:- lne�7125
Name of person making stat ent. Name of person making state n
aally OR Pr duced Identification Perso , y Kn wn OR Pr u d Identification
Tti Ty of Iden fication
Pr�'duced
(Sign ure of No ary Pub1'�tate`of-Flofid"a (Sig ture of N ary Public-S te�o fq lda�)
<orau•,, JOH MICHAELFERRICK ;,•t�YP�•,, JQHNMICHAELFERRICK F
CO mission N =°x ��'_ No ��yy__P}4� lic-State of Florida r°, n`�= Nifty Public-State of Florid
° ��1i'�sion#GG 12041 B CO ' mIS51 On =. * .( eammission#GG 120418
q° �oP:, My Comm.Expires Aug 26,2021
OFF°•' ndedthrou hNationalNotaryAssn. F-F�°P°: My Comm.Expires Aug26,20 1
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.5/6/20