HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO.BE ACCEPTED
Date: Permit Number: a2 to a-o o--)-
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- 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 F R:
J�uWCI n
RROPOSEQ:IMPRC►VEMENT LOCATION.
Address: 9celf_'
Property Tax ID#: —1 c� Lot No.
Site Plan Name: Block No.
Project Name: C ��
'DETAILED DESCRIPTION OF 1NORK ,.
na e,
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 _Shutters _Windows/Doors _Pond
_Electric —Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Constructiow. \ Sq. Ft. of First Floor:
Cost of Construction:$ (J Utilities: —Sewer _Septic Building Height:
,..GINNER/LESSEE. CONTRACTOR;
vy �_.. ;
Names (" ) Name:Steven C Mears
Address: Company:Lifetime Exteriors
City: sApn6h State:EL Address:102 South F St
Zip Code: `29 q,�3 � Fax: City: Lake-Worth State:Fl
Phone No. S�' 3d f'�J�2C Zip Code. 33460 Fax: 561-582-7505
E-Mail: Phone No561-533-8700
Fill in fee simple Title Holder on next page(if different E-Mail Diane@Lifetimeexteriors.net
from the Owner listed above) State or County License COC1529442
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.
S'UPPLEMENTAL.CONSTC UCTION LIEN LAIN CNFORMATION,
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 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.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/Lice Holder
STATE OF COUNTY OFO 146M n COUN STATE OF FORIDAko'A-Vew
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
X P ysical Pres ce or Online Notarization x Physical Pres "ce or Online Notarization
this_S day oft,A7ilr/ c 2020 by this Ze7 day ofk,/jWU,4ffL7 2020 by
Name per n making stat ent. Name of per n making state nf.
Pd'rsonally own OR Pr d ed Identification '>4 Per Wally Kno n OR Pro ced Identification
Type of Id tificati T e of Ident' icat n
Produced Produced
(Sign ture of No ry i?ubli�,,��e of 6T'dFi fflA (Si ature of N ary Pub4ic=,5fate=of}Florida� Notary Public-State of Florida JOHNMICHAELFERRICK
Com i�Si--on GG 120A18
CO mission No `•_* MyComt�lsAug26,2021 Commission N =_; .°=, Notarl�i State of Florida
Bonded through National Notary Assn '; COmI55lor1nGG120418
9jFORo�: M Comm.Expires Aug6,2021
o :. Y P 9
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE .
COMPLETED
ev.5/6/20