HomeMy WebLinkAboutpermit 7304 BANYAN STAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
1 rr
ate,;
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 LOCATION:
Address: 3 0 i C inyA bU
Property Tax ID #: 1-1 d — — Lot No.
Site Plan Name: Block No,
Project Name:
DETAILED DESCRIPTION OF WORK:
/1
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:S"59
�1
Shutters _ Windows/Doors Pond
Generator X Roof 5 /d Pitch
Sq. Ft. of First Floor:
Cost of Construction: $ �Q�S00 Utilities: Sewer Septic Building Height:
OWNERAESSEE:
Name q_20A-4ar-
Address: I lD6 ra
City. State:
Zip Code: a Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
'CONTRACTOR:
Name: rim 91!/� 4
Company: eo' " 4
Address: LAI i /YYI nL
City: � �crlCl� State: FG
Zip Code: ��
9 Fax:
Phone No 7?a- 3'70 +Q77 -0
E-Mail ?Ao_4n L L C /f'1Gi�+ .Ga ►„�,
State or County License_ CCf'6Gs,3
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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
is
which 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 Contra /Lic older
STATE OF FLORIDA STATE OF FLO%IP-A
COUNTY OF COUNTY OF t
Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization V Physical Presence or Online Notarization
this day of 2020 by this day of 2021 by
3•n
Name of person making statement. Name of person making statem nt.
Personally Known OR Produced Identification Personally Known V_ OR Produced Identification
Type of Identification Type of Identification
Produced Produced
-��d jw::��a
(Signature of Notary Public- State of Florida) (Signature of Notary/Public- State f Florida )
(Seal) Commission No.
Commission No. Seal (� a�a (Seal)
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