HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
�'r
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial x Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 2300 Virginia AVE, Fort Pierce, FL 34982
Property Tax ID#: 2421-601-0050-000-6 Lot No.21
Site Plan Name: Block No. 35S
Project Name: SLC Environmental Services
DETAILED DESCRIPTION OF WORK:
Replacement of Door with Impact j
FL NOA 29078.2
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 _ Pond
_Electric _Plumbing _Sprinklers _Generator —Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 2,477.00 Utilities: -Sewer _Septic Building Height:
ffAddress:2300
ER/LESSEE: CONTRACTOR:
ST LUCIE COUNTY Jeffrey Name: y Walsh
Virginia Ave Company:Liberty Impact Windows and Doors
City: Fort Pierce FL _ 257 SE Monterey Road East
State: Address:
Zip Code: 34982 Fax: City: Stuart FL
State:
Phone No.772-486-7711 34994
Zip Code: Fax:
E-Mail: Phone N0772-444-7112
Fill in fee simple Title Holder on next page( if different E-Mail
from the Owner listed above) State or County License CGC 1528257
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: FL City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ 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
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 Crdpa
ed on the jobsite before the first inspection. If you intend to obtain financing, consult
with I rne before commencin work or recording-your Noti'ce`of Commencement.
Signat oontractor as Agent for Owner Signature kff Contralctor/Licegse Holder
g
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF a?ccr tCo COUNTY OF MA"-it
�_wrgrn to(or affirmed)and subscribed before me of Sw rn to(or affirmed)and subscribed before me of
Physical Presen r Online N tarization Physical Prese or Online N tarization
this day of 202� by this day of 202� by
Name of person making Statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known V/OR Produced Identification
Type of Identification
Produce Type of Identification
Produped
(Signat otary Public-State aWcT ture of Notary Public-State ci&R
CHRISTINA FORTIN oc
;aoF 'c<•.. CHRISTINAFORT!,
Commission No. G G /�W fey ;•� Notary Public-State o lorida / 6 C���uF l� ��..
v�\, l) Commission GG 937 6�0 ISSIon N / / 7 �� Diary Public State o :o a
•''':`.�oFFt�-* My Comm.Expires Dec 5 2023 +�L.l�h:`I, ..•• Commission k GG 937 6
3onded through National Nota Assn. r�'r.' My Comm.Expires Dec 5 2 3
' onal No., v sn
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
DATE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
RECEIVED
DATE
COMPLETED
ev.