HomeMy WebLinkAboutBuilding Permit Application E COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Building Permit Application
es
Commercial' Residential x
0032 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462--1578
PERMIT APPLICATION FOR;Arr0W Shed Code enforcement case
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Address: 8002 Westmont Dr
Property Tax ID#: 1301-603-0181-00010 Lot No.
Site Plan Name: Block No.
Project Name:
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10x14 Shed with Wood Flooring
Has been in place for 23 months
New Electrical Meter Second Electrical Meter
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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..129_ _ Sq.Ft.of First Floor:
Cost of Construction:$600 Utilities: Sewer _Septic Building Height:
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Name Kathryn&Dewayne Potter Name:Same as Owner
Address:8002 Westmont Dr Company:
City: Fort Pierce State:_ Address:
Zip Code:34951 Fax: 'City: State:
Phone No.772 200-5158 Zip Code: Fax:
E-Mail:potter.Kathryn.a@gmail.com Phone No
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License
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 Ndtice of Commencement Is required.
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:w-cooi-
Address: Address:Poeuxssma
City: State: City: o State: Tx
Zip: Phone Zip: 75M Phone: -243
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name.-
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR"AFFIOVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
1 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,)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 Oran attomey before commencing work or recording our Notice of Commencement.
a'"
!SYgnature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF sum COUNTY OF
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presence or Online N tarization Physical Presence or Online Notarization
this day of. 202� by this day of .2020 by
Name of person making statement ame of person making statement.
Personally Known OR Produced Identification Personalty Known OR Produced Identification
Type of Identification Type of Identification
Produced !;a� Produced
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
�SPpy pU��� ELLEN V ��jj��N
Commission N FloridaCdry Public Commission No.- (Seal)
=* Commission # GG 270079
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v ojj1``.
__ __ ctober 22, 20 2
REVIEWS m5MRVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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