HomeMy WebLinkAboutPermit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
o
`� L�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: 1801 N 31st Street, Fort Pierce, FL 34947
Address: 1801 N 31st Street, Fort Pierce, FL 34947
Property Tax ID #: 2405-501-0113-000-2
Site Plan Name:
Project Name: Wanda Dawson
I DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Lot N o. 21 & 22
Block No. 5
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:
Cost of Construction: $ _lsj r�w—
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Wanda Dawson
Name: Scott Berman
Address: 1801 N 31st Street
Company: Florida Window & Door
City: Fort Pierce State: _
Zip Code: 34947 Fax:
Phone No. 772-882-2496
Address: 1125 N Dixie Highway
City: Lake Worth State: FL
Zip Code: 33460 Fax:
Phone No 561-340-4300
E-Mail howard@floridawindowanddoor.com
E-Mail: wandadawson92@yahoo.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
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 LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable
MORTGAGE COMPANY: x Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
BONDING COMPANY: x 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 County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with le der or n attorneybefore commencingwork or recordingour Notice of Commencement.
('16-u JV1 h� 7-5���
Signature of Owner Lessee/Contract as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA «-'
COUNTY OF St. Lucie COUNTY OF Palm Beach �fl ft .41
Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of r K
1 Physical Pre ence or Online Notarization x Physical Presence or Online Notarization � o a
this day of 2-&M by this 21L day of 202U by a3 D
Do 3
Wanda Dawson Scott Berman n =' m
Name of person making statement. Name of person making statement.
L4�-
Personally Known OR Produced Identification C6 Personally Known x OR Produced Identification
Type of Ide,4tification Type of Identification
Pro ed U 4 619 -G 1b Pr ced
( Nw— I(A � h� �N
0 0� LA,
(Signs ure of otary Publicr�t:•9� Sig ure of'Notary Public- State of Florida )
"a+.^,R Notary Public State of Florida
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Commission No. a Cris {j Hamersla mmission No. (Seal)
.r ply to�rrl m"ssion GG 343472
Expires 07/0912023
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