HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
IM WOE
0
^° ° M 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: 7403 Coquina Avenue Fort Pierce, FL 34951
Property Tax ID #: 1301-607-0096-000-9
Site Plan Name: LAKEWOOD PARK -UNIT 7
Project Name: Donaldson Truss Repair
Q.
Lot No.19
Block No. 73
DETAILED DESCRIPTION OF WORK:
Remove existing shingles and plywood. Repair existing broken trusses per engineer's design. Install new
1/2" plywood and dry in for roofer.
New Electrical Meter Second Electrical Meter
-;CONST:RUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters
Electric _Plumbing _Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 204b
_ Generator
Sq. Ft. of First Floor:
Windows/Doors _ Pond
Roof Pitch
Utilities: —Sewer —Septic Building Height:
;OWNER/LESSIEE�E::
CONTRACTOR: =
Name Elizabeth Donaldson
Name: Douglas Sammons
Address:7403 Coquina Avenue
Company: Hall -Sammons Inc.
City: Fort Pierce State: _
Address: 1161 NE Martin Avenue
Zip Code: 34951 Fax:
City: Jensen Beach State: FL
Phone No. 772-332-2233
Zip Code: 34957 Fax:
E-Mail: lizd90@yahoo.com
Phone No 786-337-5107
Fill in fee simple Title Holder on next page (if different
E-Mail eden.hallsammonsinc@gmail.com
from the Owner listed above)
State or County License CRC1326546
it value of construction is Z500 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.
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DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: — Not Applicable
BONDING COMPANY:
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 lender or an attorney before commencing work or rem your Notice of Commencement.
as AgEnt for Owner
STATE OF FLORIDA I STATE OF FLORIIIA
COUNTY OF SY L tX- COUNTY OF SS
Sworn o (or affirmed) and subscribed before me of
Physical Presence or' Online Notarization
this _, clay of 2020 by
Name of person making statement.
Personally Known
Type of Identification
Produced'
OR Produced Identification
Holder
Sworn to (or affirmed) and subscribed before me of
_-"Ph sical Presence or Online Notarization
this day of -(_�-09 2020 by,
Name of person making statement.
Personally Known OR Produced Identification frC-
Type of Identification
Produced FL,1RL__
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t3i8ndture
IVp`�F� •,YUDIIC- J rlga )
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Notary Public State of Florida
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SAVITRI GARCIA
Notary Public -Sta
Commission
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My Comm. Expires Apr 1, 2024
My Comm. Expires Apr 1, 2024
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