HomeMy WebLinkAboutBuilding Permit Application ' I
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All APPLICABLE INFO MUST!BE COMPLETED FOR APPLICATION TO BE ACCEPTED rr__ 1
Date: Permit Number: W 1
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9117.W C. 12
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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: _
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PROPOSED IMPROVEMENT LOCATION:
Address:3000 HIGHWAY AIA UNIT 12D,FORT PIERCE,FL 34949
Property TaxlD#: �y1��.53 ��.?�' `75G� 06L!3�—000--o Lot No.
Site Plan Name: Block No.
Project Name:JOHNSON,STEVE
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DETAILED DESCRIPTION OF WORK:
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INSTALL 4 ACCORDION SHUTTERS
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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:'710.1 Sq. Ft.of First Floor:
Cost of Construction: $13386.20 Utilities: , _Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
NameJOHNSON,STEVE Name:Jeffrey ToUison
Address:478 W 132ND PL Company:LEVINSON BUILT,LLC
City: CROWN POINT ; State:IN Address:1638 Donna Road
Zip Code: 46307 Fax: City: West Palm Beach State:FL
Phone No.219-743-9933 j Zip Code:33409 Fax:
E-Mail:SAJ@JOHNSONI.COM Phone No 561-712-9882
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Fill In fee simple Title Holder on next page(if different E-Mailpermits@levinsonbuilt.com
from the Owner listed above) State or County License CGC 1512423
If value of-construction is 2500 ar 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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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
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FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: - Phone: Zip: Phone: l
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indjcated.
I certify that no work or installation has commenced prior to the issuance of a permit. f
St. Lucie County makes no representation that is granting apermit 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 cons ult'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 recording our Notice of Commencement.
Signatu ne Fee/96ntractor as Agent for Owner Signature of ntr r/Lice se Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 31 C�`� �c �1� COUNTY OF QS't-N
Sw,Qrn 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-Z LP day of_ /LV_t-c _ 2024 by this'LlQ day of tt ,202Q by
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Name of person making statement. ° Name of person aking statement.
Personally Known V OR Produced (dent' i 1 o``0c Personally Known %/ OR Produced Identifica 3n
Type of Identification W o Type of identification g `3
Pro ced -n a o Produced ?a N
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ignature of Not y Public(St to of ida) ��.;t o ignature of No ry Publ' - tate F rida). N`
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Co mission No. (Seal) a v �'o Commission No. (Seal) o
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REVIEWS FRONT ZONING SUPERVISO PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER! REVIEW REVIEW REVIEW REVIEW REVIEW. REVIEW
DATE
RECEIVED
DATE
COMPLETED
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