HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Oro RTCM
CQ.�',.
V a a P Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1S53 Fax: (772) 462-1578
PERMITAPPLICATION FOR:
rPROPOSED IMPROVEMENT LOCATION:
Address: 355 PALMS AVE, FORT PIERCE , FL 34982
Property Tax ID#:3403-501-0154-000-8 Lot No.
Site Plan Name:
Project Name: WILLIAM & PATRICIA RODGERS
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical
CONSTRUCTION INFORMATION:
Block No.
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 Construction: Sq. Ft, of First Floor:
Cost of Construction: $ 22,000 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameWILLIAM & PATRICIA RODGERS
Name:DAN BECKNER
Address:355 PALMS AVE
Company: PARADISE EXTERIORS LLC
City: FORT PIERCE State: FL
zip Code: 34982 Fax:
Phone 1\10.772-240-5710
Address:1918 CORPORATE DR
City: BOYNTON BEACH State:FL
zip Code:33426 Fax:
Phone No 561432-0300
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail permits.paradiseext@gmail.com
State or County License SCC131150472
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
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
City: _
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permitto 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 usesto 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 Innriar nr nn nttnrnaiLhafnra rnmmenrina work or recordine vour Notice of Commencement,
SSI
Sign of Contractor/License Holder
STATE OF FLORIDASTATE OF FLORIDA . /+
COUNTY OF �11 �C��
Svybrn to (or affirmed) and subscribed before me of
�/ Physical Presence or___ Online Notarization
this'2� day of P6�� 202p by
ATIICIA �OPGteaS
Name of person making statement.
Personally Known /.OR Produced Identification___
Type of identification
Produced____ _
(Signature of Notar ic- State of Florida )
Commission No. ____ (E�91rS D. HOWELL
(/��) MY COMmiss N GG916937
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SWAM to (or affirmed) and subscribed before me of
�Physical Preece or _Online Notarization
i' Ir day of �_, 2024 by
Name of person making statement.
Personally Known _ OR Produced Identification
Tvoe of Identif cati
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�RPIRES: Novembbeer 19, 2024
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