HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1/11/2021 Permit Number:
gvo UECULE RECEIVED
o -JAN 2 1 1021
Building Permit Application
Planning and Development Services Permitting Department,5t.,Lucietcounty
Building and Code Regulation Division Commercial Residential xx
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553. Fax: (772) 462-1578
PERMIT APPLICATION FOR: Dock
PROPOSED IMPROVEMENT LOCAT;ION:..
Address: 6601 south indian river dr
Property Tax ID #: 3412 14.1 0001 000 5 Lot No.;
Site Plan Name: Block No.
Project Name: Pruitt Dock
DETAILED DESCRIPTION.OF WORK:
Install dock
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
Electric _ Plumbing' _ Sprinklers, = Generator _ Roof' 'Pitch
Total Sq. Ft of Construction: Sq: Ft: sof`First`Floor:
Cost of Construction: $ 10,000.00 Utilities:' •Sewer 4 ' `Septic wilding Height:"
OWNERXESSEE
Name robert and kimberly pruitt
Name:
Address: 6601 south indian river dr
Company:
City: ft pierce State: _
Address:
Zip Code: 34982 Fax:
City: State:
Phone No. 772-349-0702
Zip Code: Fax:
E-Mail:robert.pruitt@pruittindustrial.com
Phone No
Fill in fee simple Title Holder on next page ( if different
E-Mail
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.
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable "
Name:
Address:
City:
Zip: Phone:
UWNt:K/ LUN I KAL. I UK AhFIUV 11: 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 vour Notice of Commencement.
Z,
Signature of owner/ Lessee/Contractor as Agent for Owner
STATE OF FLO
COUNTY OF �h I
Swc/n to (or affirmed) and subscribed before me of
cV Physical Pr s e o O line Notarization
this day of 2020 by
Name of person making statement.
Personally Known 4uced WR@gV%at�
pe of Identificati _; 1 Notary Pu .State of Florida
,P ced COTT
sio q GG 937394
I I,/fi Y fx fires Dec 5, 2023
of NoTary PbMlic-date of FI
Commission No. (Seal)
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of 2020 by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
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