HomeMy WebLinkAbout5100 Palm Drive permit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2/24/2021 Permit Number:
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: I Sass p'X" C-
PROPOSED IMPROVEMENT LOCATION:
Address: 5100 Palm Dr., Fort Pierce, FL 34982
Property Tax I D #: 3402-608-0349-000-7
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Garage wall re -build as needed around garage door only as per engineered plans
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
— Electric —Plumbing _ Sprinklers _ Generator _ Roof
Total Sq. Ft of Construction:
Cost of Construction: $
cxj—
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic
X
Lot No.1
Block No. 50
Building Height:
Pond
Pitch
OWN ER/LESSEE:
CONTRACTOR:
Name Duwaine & Terrie Norman
Name:John Jacobs
Address:5100 Palm Drive
Company:John Jacobs Construction Inc.
City: Fort Pierce State: L-
Zip Code: 34982 Fax:
Phone No.
Address:4701 Oleander Ave
City: Fort Pierce State: FL
Zip Code: 34982 Fax: 772-466-6491
Phone N0772-882-8334
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail imiacobs4701@gmail.com
State or County LicenseCBC060421
If value of construction is Z500 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
Name:
Address:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
City:
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 attorne before commencin work or recordin our Notice of Commencement.
Signa e of Ow es ontract nt for Owner
Sign re of Contracto, / icense Hol r
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Sw rn to (or affirmed) and subscribed before me of
Swprn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
_X_ Physical Presence or Online Notarization
this dq day of Sk bru,,!, 2020 by
this _, day of Fe i (-M c—G 2024 by
Name of person making statement.
Name of person making statement.
Personally Known V OR Produced Identification
Personally Known^ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
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REVIEWS
FRONT
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SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/b/2U