HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a.111 a,d Permit Number: oil;
91T, U Q rs
Planning and Development Services
RECEIVED
Building Permit Application DECO 2 2020
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Permitting Department
ResidentiaMcleCounty
PERMIT APPLICATION FOR: I nstal I i na a Shed �,a
Address: 5612 Cassia Drive
Property Tax I D #: 3402-610-0266-000-8
Site Plan Name:
Project Name:
New Electrical Meter no Second Electrical Meter no
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping
Electric _ Plumbing
Total Sq. Ft of Construction: 240'
Cost of Construction: $ 2000
Name Russell A. Schroeder
Address:5612 Cassia Dive
Sprinklers
Lot No. 1
Block No. 79
Shutters _ Windows/Doors _ Pond
Generator Roof Pitch
Sq. Ft. of First Floor: 2403
Utilities: —Sewer —Septic Building Height: 10'
City: Fort Pierce State:
Zip Code: 34982 Fax:
Phone No. 772-285-8448
E-Mail: MrRschroeder(aD-gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name:
Company:_
Address:
City:
Zip Code:
Phone No
E-Mail
State or County License
Fax:
State:
f value of construction is 2500 or more, a RECORDED Notice of Commencement is
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
N'S ,,,,,
DESIGNER/ENGINEER: _ Not Applicable
Name: Davis & Cleaton Engineering, Inc.
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:280 Wakiva Springs Road, Suite 1080
Address:
City: Longwood State: FL
City: State:
Zip: 32779 Phone (407) 539-2353
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 aid 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.
ILA
Signature of Owner/ Lessee/ ntractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA �
STATE OF FLORIDA
COUNTY OF AV]AE- T7/D(Y
COUNTY OF
Sw9rn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or nline Notarization
this day of C' , 2020 by
�USS�LL &_
Physical Presence or Online Notarization
this day of , 2020 by
Name of person making statement.
Name of person making statement.
Personally Known OR ProducoA Identification
Personally Known OR Produced Identification
ype f Identificat`o
Produ ed i�L (
Type of Identification
Produced
(Si n ture of N
(Signature of Notary Public- State of Florida )
C mission No
JENNIFER L. RIEGELSBERGER
`fir p°�G Notary Public. SItN&?)Florida
Commission# GG 132408
Commission No. (Seal)
My comm. expires Aug. 7, 2021
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