HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: `' 0"-J1jPermit Number: r f�
RECEIVED
JAN 2 8 2021
Permitting Department
Building Permit Application St. Lucie County
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.:IIVLPROVEMENT LOCAT..ION.
„x
Address: 1200 Country Garden Ln
Property Tax ID #1403-502-0228-010-4 Lot No.213
Site Plan Name: White City S/D 09 36 40 From NE Cor Lot 213 Run W 240 Ft For POB, Th Cont Block No.
Project Name:
'DETAILED DESCRIPTION'OF WORK:
Tear off & Reroof 0/12 Pitch 5sq using Polyglass FL1654-R7 (W 212)
3/12 Pitch 20sq using double 301b felt & Certainteed Landmark Shingles
New Electrical Meter Second Electrical Meter
CONSTRUCTfON_ ON I'NFORMAT(
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: 2500
Cost of Construction: $ 7500
Sq. Ft. of First Floor:
Utilities: —Sewer _ Septic Building Height:
bWNER/LESSEE:. '
CONTRACTOR:.
Name Gerald Creighton
Name: Owner Builder
Address:1200 Country Garden Ln
Company:
City: Fort Pierce State: _
Address:
Zip Code: 34982 Fax:
City: State:
Phone No. 71 Z.- e7_z>t4-_zx'J4b
Zip Code: Fax:
E-Mail: ni►andahAe2QM
Phone No
E-Mail
Fill in fee simple Title Holder on next page ( if different
State or County License
from the Owner listed above)
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.
srSUPPLEMENTAL CONSTRUrCTION
LIEN LAW 1NF6'6kMATION
�t
xM, `iX �.,, .t L,uA4 .t ,,, n4^W�,. .'sa l_l•n, Q.s.
t�2 swrv`4
.�, ',F;
,s� .. T+3.,
dx"n,a...+� .. .1 ?°e n,'� ..� .ircC
a 1,'.: .P. Mu.
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER:
_ 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 con -currency 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 recordine vour Notice of Commencement.
i ature of Owner/ essee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
Svi n to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Pres nce or Online Notarization
Physical Presence or Online Notarization
this day of 2024 by
this day of 2020 by
Name of person making statement.
Name of person making statement.
/
Personally Known i OR Produced Identification '✓
Personally Known OR Produced Identification
Type of Identifica
Type of Identification
Produced I
AA
Produced
(Signature of Notary Pu c ,,S of FIN S. N I ELSEN (Signature of Notary Public- State of Florida )
lP VB
tate of Florida -Notary Public
Commission No. Co ion # GG 207484 Commission No. (Seal)
M of mission Expires
OF FLOP
Ill%% ` June 12, 2022 11
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev.b/b/LU