HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
O
17 TOOTF9209
Permit Number:
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
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 205 Holly Avenue, Port St. Lucie, FL 34952
Property Tax ID #: 3419-510-00301-000-1
Site Plan Name:
Project Name: John Fox
Residential x
Lot No. 2
Block No. 21
I DETAILED DESCRIPTION OF WORK: I
Ct t 1 rr,, P ros�-_�,\ t As
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
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ [I, Q ..5% "
Generator
Sq. Ft. of First Floor:
Windows/Doors _ Pond
Roof Pitch
Utilities: —Sewer —Septic Building Height:
OW N ERAESSEE:
CONTRACTOR:
Name John Fox
Address: 502 Holly Avenue
City: Port St. Lucie State: _
Zip Code: 34952 Fax:
Phone No. 772-528-4012
Name: Scott Berman
Company: Florida Window & Door
Address: 1125 N Dixie Highway
City: Lake Worth State: FL
Zip Code: 33460 Fax:
Phone No 561-340-4300
E-Mail howard@floridawindowanddoor.com
E-Mail: wwatsonl 126@gmail.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License CGC1509450
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:
Name:
;,.
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City:
Zip: Phone
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE Fl0LDER:
Name:
_ Not Applicable
BONDING COMPANY: _Not Applicable
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.
I tiriP rnnnty and nosted on the iobsite before the first inspection. If you intend to obtain financing, consult
an attorney before commencing work or recording your N
of Owner/ Lessee/Con ractor as Agent for Owner Signature of Contractor License Holder
STATE OF FLO ID&- STATE OF FLORIDA
COUNTY OF�1
� , COUNTY OF P --
Swor o (or affirmed) and
Ph Ical PresAeSc�ero�r.
this ay of l�r' yr
John Fox
Name of person making st;
me o-f rn o ffirmed) and subscribed before me of
JINA M. CIC y
ri to Qh sica Presence or Online Notarization
yRMY Public, St tela Flor' �a of ier,, q 2020 by
Commission# - G 956644
making statement.
onally Known OR Produced Identification
Personally Known x
OR Produced Identification
ype o enti cation
Typel dentification
Produced
Pro
ce
� ,fin
' t ►►tea 1 r . �, i f-fj L
(Signature of Notary Public- State of Florida )
(Sgnature of Notary ub ic- State of Florida !
Commission No. (Seal)
Commission No.
(Seal)
REVIEWS
FRONT
ZONING
I SUPERVISOR
PLANS
VEGETATION
FSEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
EVIEW
REVIEW
DA rE
RECEIVED
DATE
COMPLETED