HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED t�
Date: Permit Number:
RECEIVED
C o APR : 9 2021
° ' Building Permit Application rw-itting Department
St. LLIde County
Planning and Development Services
Building and Code Regulation Division Commercial Residential x
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR: 5v' .CS
PROPOSED IMPROVEMENT LOCATION:
Address: 7605 Hibiscus Road
Property Tax ID#: 1301-605-0041-000/3 Lot No.15
Site Plan Name: Block No. 41
Project Name: Dennis Residence Lakewood Park Unit 5
DETAILED DESCRIPTION OF WORK:
Install metal and clear shutters on,existing residence. All 0a
o—
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 X Shutters _Windows/Doors _Pond
_Electric _Plumbing _Sprinklers Generator _Roof Pitch
Total Sq. Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction: $ 1825.00 Utilities: .—Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
NameJohn and Mary Dennis Name:John Dennis
Address:7605 Hibiscus Road Company:John Dennis Construction Co.
City: Ft. Pierce State:— Address:7605 Hibiscus Road
Zip Code: 34951 Fax: City: Ft. Pierce State:FL
Phone No.772 464-2073 Cell:772 519-3175 Zip Code: 34951 Fax:
E-Mail:jdconstructionco@bellsouth.net Phone N0772 464-2073 Cell: 772 519-3175
Fill in fee simple Title Holder on next page(if different E-Mailjdconstructionco@bellsouth.net
from the Owner listed above) State or County License SLC 22686 / State CBC 015435
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:N/A Name:N/A
Address: Address:-
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: ,Not Applicable BONDING COMPANY: _Not Applicable
Name:NIA Narne:N/A
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 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.
Signatu of Owner/Lessee/Contractor as Agent for Owner Signatu of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 5 COUNTY OF SS .1—�c
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization Physical Presence or Online Notarization
this X!day of 202b by this ��day of (k P C�_ .2020 by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced lq•V 1D l4. Produced p L
(Signature of Notary blic-State of Florida) (Signature of o P - tale f
iVENS ;.••"Ppv'6��•.,. EANNAGIVENS
Commission No. tit e Pitate of��0"°a Commission N �!i ubiic-scare pf�@Ipa
Notary HK 086359 'sy p Com issior.#HH 086359
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DATE
RECEIVED
DATE
COMPLETED
ev.5/6/20