HomeMy WebLinkAboutApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
S��o U!CLC.' _.";7,
c c--- 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: 12478 HARBOUR RIDGE BLVD 3-2 PALM CITY, FL, 34990
Property Tax ID #: 4426-510-0018-000-5
City Plan Name -
Project Name: ZAMMIT
Lot No._
Block No.
DETAILED DESCRIPTION OF WORK:
REPLACE 3 DOORS SIZE -FOR -SIZE WITH IMPACT
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 _ Shutters _ Windows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 24613 Utilities: —Sewer —Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name VALENTINE ZAMMIT
Name: Roberto Sanchez
Address: 12478 HARBOUR RIDGE BLVD 3-2
Company: The Home Depot
City: PALM CITY State: _
Zip Code: 34990 Fax:
Phone No. 516-660-5109
Address: 2455 Paces Ferry Rd
City: Atlanta State: GA
Zip Code: 33039 Fax:
Phone No 754-224-2010
E-Mail: valzammit@aol.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail robertosanchezthd@expeditepermit.com
State or County License CGC1522717
If value of construction is 2500 or more, a RECORDW Notice of t,ommencement is requlreu.
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
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
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
...i+h lnnHl r nr nn a++nrnov hAfnrP rnmmPnrina v,,nrk nr rPrnrdinE vour Notice of Commencement.
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FL07A
COUNTY OF /�`
COUNTY OF r.44r
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 /5 day of �/j�riz 12029 by
this � day off , 2020 by
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Name of person making statement.
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Name of person making statement.
Personally Known / OR Produced Identiiii
Personally Known OR Produced Identificati
Type of Identification
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Type of Identification
Produced
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Produced
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(Signature Notary Public- State of Florida)
(Signature of Notary Public- State of Florida) > 0
Commission No. �Q`�5��� (Seal)
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Commission No. �b sy 77 (Seal)
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DATE
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DATE
COMPLETED
Rev. 5/6/21D