HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COM�ie iED FOR APPLICATION TO BE ACCEPTED
Date: 06/01/2021 Permit Number:
1 uu
O
Building Permit Application
Planning and Development Services
Building and Code Regulation. Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
dress: 8390 hidden pines road
Commercial Residential yes
Property Tax ID #: 23237010006002 Lot No.6
Site Plan Name: Block No. a
Project Name:
New Eli dtrical Meter Second Electrical Meter
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• rUtilities: _Sewer _Septic Building Height:
OWNER/LESSEE YYgt�
CONTRAC ti
Namejames decarolis
Name:
Address:8390 hidden pines road
Company:
Address:
City: ft pierce State: _
Zip Code: 34945 Fax:
City: State:
Phone No.56,14366643
Zip Code: Fax:
Phone No
E-Mail: rpcabinetry@aol.corn
E-Mail
Fill in fee simple Title Holder on next page ( if different
from;the OwnerIlisted 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 Not!ce°of Commencement is required.
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:
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. attornev before commencing work or recording vour Notice of Commencement.
E"Sig ' a` ,re of Owner/ Lessee/Contractor as Agent for Owner I Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF 5+-
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Preser1ce or Online Notarization
Physical Presence or Online Notarization
this __t day of Q 202# by
this day of 12020 by
zumeS e Q�ro1�s
Name of person making statement.
Name of person making statement.
Personally Known OR Pro \\ 1 1j' tifica ��
Personally Known OR Produced Identification
Type of Identificati n V N srat EC EN
core
a of Identification
Pro 'ice F P\ qw'
Of Fiorida'q
rY
�6
®h® R" .:
P�bli
�1- 079
(Signature of N
�' 1n ure of Notary Public- State of Florida )
`�1PpYJJ"' ELLEN VA1UGHN
,r� � state of Florid�SEal)f ;'"''r
Commission No. -
Comm ission No. (Seal)
IV 1 L
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED