HomeMy WebLinkAboutPermit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
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:
Residential x
Address: 333 Barraclough Street, Fert Pierce, FL 34982
Property Tax ID #: 3403-802-0030-000-7 Lot No. 2
Site Plan Name: Block No. 3
Project Name: Ramona Rodriguez
DETAILED DESCRIPTION OF WORK:
1 S
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:: r.r/,
Cost of Construction: $ 11, *0
Sq. Ft. of First Floor:
Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Ramona Rodriguez
Name: Scott Berman
Address: 333 Barraclough Street
Company: Florida Window & Door
City: Fort Pierce State: _
Zip Code: 34982 Fax:
Phone No. 772-216-6910
Address: 1125 N Dixie Highway
City: Lake Worth State: FL
Zip Code: 33460 Fax:
Phone No 561-340-4300
E-Mail: ramonar85@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail howard@floridawindowanddoor.com
State or County License 28576
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 LAIN INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable I MORTGAGE COMPANY: X Not Applicable
Name:_
Address:
City:
Zip:
Phon
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
State:
x Not Applicable
Name:_
Address:
City:
Zip:
Phone:
State:
BONDING COMPANY: x Not Applicable
Name:_
Address:
City:_
Zip: Phone: I Zip: Phone:
OWN ER/ 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 attorney before commencing work or recording your Notice of Commencement.
Z,__ 17c, _ - —_
Signature of Owner/ Lessee/Co tr or as Agent for Owner
STATE OF FLORIDA
COUNTY OF St. Lucie
Sworn to (or affirmed) and subscribed before me of
Physical Pres nce or Online Notarization
this 12-. day of 2RE) by
0J-t
Ramona Rodriguez
Name of person making statement.
Personally Known OR Produced Identification�-P
Type of Identification
(Signature of Notary Public-
ofotary Public State of Florida
Commission No. � Hammersla
r mission GG 343472
dExpires 07/09/2023
Signature of1Mn ractor/License Ho er— ,
STATE OF FLORIDA
COUNTY OF PalmBeach
Sworn to (or affirmed) and subscribed before me of
4 Physical Pres c or Online Notarization
this � day of 24" by
Scott Berman
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
ignature of N6fary Pu c? �bTary`T 1-4lic- State of Florida
Carol A Hammersla
mmission No. = �, or My
cona� lSei2023 343472
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 6 20