HomeMy WebLinkAboutEverhard Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 f1z 1' 2-1 Permit Number:
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:
PROPOSED IMPROVEMENT LOCAPON
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Address: 4305" rmit.,J00cy r I'-' 2'ei'u rL 3,4c"51
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:_ Vg,Y-r1aeM-
DETAILED DESCRIPTION OF WORK
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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
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: 54C,
Cost of Construction:$
_ Shutters _ Windows/Doors Pond
_ Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
Name_VV,'JJj(1 VI Fs1,P. hinA
Address:Ar3q-: ` ecl smr) zzr.
City: 6Pc r,r P , State: l 1-
Zip Code: 6 i Fax:
Phone No. `7r12.4(nf)• 8,04
E-Mail:
Fill in fee simple Tale Holder on next page ( if different
from the Ownerlisted above)
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RACTOR:
Name: 1qr, et,) Hcz l l
Company:`?
Address:_°72C11 '-Uriar) J)li;rtl a,
City. 'Laccin State:
Zip Code:Zaa-" :l Fax:
Phone No 727- 71,Z+ - 0,7J(X
E-Mail o'ern 6f rrata
State or County License 612-j3(�8R44
nvULAC v1 wmmencement is requirea.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPP EMENTAL CONSTRUCTION LIEN LAW INrORMATf N:
DESIGNER/ENGINEER:
Not Applicable
Name:
Address:
City:
State:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
& Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
of Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to clothe 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 attornev before commencine work or recnrding vniir Alrffiea of rnrnmanrcrr an+
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
TIFFANY M.HIGGINS
STATE OF FLORIR�4
STATEOF FLORIDA
COUNTYOl=Notary Public -State of FloridaCOUNTYOF
My Commission Expires
Sworn to (or affirmribe4�reCUf, 2024
Sworn to (or affirmed) and subscribed before me of
"�
Physical Prese
this day of `l_ VI,,\ L.ti(1.' 2029 by
Physical Presence or Online Notarization
this ZZ day of ��C_d)�, Ct,1Y�,j 20N by
{.
,'t t4 I
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 Identification
Produced -
Produced L
FANY M. HIGGINS;
(Signature of Notary Publ f,-Florida F ublic-State of Flo
'd
nature Notary u _* t u rc- tate o onde
'• =� ;.:runissiar # Nhi 3835
Commission No.� ` +(Seh1)rmm�is sion Expire
C
_ ission # HH 38358
q' My Commission Expires
4� �
�a•rtember 0'I, 2024
■•'`
mission No. �-{I ealj,ber 01, 2024
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