HomeMy WebLinkAboutBuilding permit Application,All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTE
Date:
C 0 LLuDL
D.C.,�"�
Planning and Development Services
Building and Code Regulation Division CO m m e rc i al
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 4624553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address: 4401 Matanzas AVE Fort Pierce, FL 34946
Property Tax ID #: 1431-801-0189-000-4
Site Plan Name:
Project Name: Guzmai
Replace 6 windows size -for -size with impact
New Electrical Meter
Second Electrical Meter
Permit Numbers
Residential X
Lot No. 1,2,3
Block No.
16
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:
Cost of Construction: $ 6469
Sq. Ft. of First Floor:
Utilities: ' _Sewer _Septic Building Height:
Name Sandra Guzmai
Address: 4401 Matanzas AVE
City: Fort Pierce Stater
Zip Code: 34946 Fax:
Phone No. (772)801-3709
..Mail* ramoncastromx77@gmail.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: Roberto Sanchez
Company: The Home Depot
Address:2455 Paces Ferry Rd
City: Atlanta
Zip Code: 33039 Fax:
P h o n e N o 754-224-2010
E-Mail robertosanchezthd@expeditepermit, corn
State or County License CGC1522717
value of construction is 2500 or more, a RECORDED Notice of Comm
If encement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
State: GA
SUPPLEMENTALCONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address: _
Address:
City$ 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
for
structure. Please consult with your Home Owners Association and review your deed 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.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF L
COUNTY OF LcIC
Sw rn 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
t is day of /1/l0��1 , 202� by
this 2 6 day of 2021 by
PSOL6i ,SC Anic" L
t
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identifi. tion
Produced
Produced
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(Signature of otary Public-
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