HomeMy WebLinkAboutPermit ApAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1/21/21 Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Address: 7671 CHARLESTON WAY
Property Tax ID #: 3321-801-0039-000-6
Site Plan Name:
Project Name:
Residential Y
Lot No. 39
Block No.
Window and door replacement, size for size - 20838.2, 18582.7, 14590.1, 16477.1, 8153.1, 14590.2, 12100.1, 12100.2
New Electrical Meter Second Electrical Meter
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:
Cost of Construction: $ 58,000
Sq.
Ft. of First
Floor:
Address:
City: State: _
Zip Code: Fax:
Phone No.
Fill in
fee
simple
Title Holder on next page (if different
from
the
Owner
listed above)
Name: Robert Cornetts
Company: Coastal Green Energy Solutions
Addres5:6710 Benjamin Rd #200
City: Tampa State: FL
Zip Code: 33634 Fax:
Phone No 813-512-6014
E-Mail Permitting@coastalgreenenergy.com
State or County License CGC1523579
f value of construction is 2500 or more, a RECORDED Notice of
ICommencement is required.
Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of
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-
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 installation has commenced prior to the issuance of a permit.
St. Lucie Count yy 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.
11Z
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Physical Presence or Online Notarization
this day of 2020 by
this \St day of 2024 by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of IdentificationProduced
Produced
(Signature of Notary Public- State of Florida)
(Signat a of Notary Pub c- State of Flo da )
Commission No. (Seal)
Commission NOM I7 1 (')d 61 (Seal)
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