HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4/26/2021 Permit Number:
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P L `, h; I b)' tti - 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:
PROPOSED IMPROVEMENT LOCATION:
Address. 33 SOVEREIGN WAY, HUTCHINSON ISLAND, FL 34949
Property Tax ID #: 1414-701-0064-000-2
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
X
4
r
Lot No. A
Block No. 8
Ds
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 _ hoof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 1Or 4 Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name David and Edith Smith
Name. John Jacobs
Address: 33 Sovereign Way
Company: John Jacobs Construction Inc.
City: Fort Pierce State:_
Zip Code: 34949 Fax:
Phone No. 772-595-9371
Address:4701 Oleander Ave
City: Fort Pierce State: FL
Zip Code: 34982 Fax: 772-466-6491
Phone No 772-882-8334
E-Mail: dsmithoceanrecon.org
Fill in fee simple Title Holder on next page (if different
from the owner listed above)
E-Mailmlacobs4701 @gmail_com
State or County License CBC060421 / 19245
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:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
Not Applicable
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.
l 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 corn encing work or recordin our Notice of Commencement.
YSTATF
SignatuVFf Owner/ Lesse / ontractor as Agent for Owner
ractor/Li a se Holder
STATE FLOMDA 1
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COUNTY OF
Swofn to (or affirmed) and subscribed before me of
5wo n to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this _Z day of D io i 2021 by
Physical Presence or Online Notarization
this 9,`3 day of A 202� by
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Name of person makin=OR
Personally KnownProduced Identification
Personally Knownroduced Identification
Type of identification
Type of Identification
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