HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /�QQ
Date: Permit Number: C, P F�y
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Building Permit Application SUN 8 0 Z021
Planning and Development Services
Building and Code Regulation Division Commercial Residents
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR:
PROPOSED,IMP, YE, LOCATION f
Address:
Property Tax ID#: ' °�Y®1�¢� Lot No.
Site Plan Name: �yii Block No.
Project Name:
DETAI.LEG DESCRIPTION OFV,WORKAg
�
Ly:
A
New Electrical Meter Second Electrical Meter
CUNSTRUCTIQN INFORMATIQN
Additional work to be performed under this permit—check all that a
_Mechanical _Gas Tank _Gas Piping VShutters _Windows/Doors _Pond
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ � eLe I Utilities: —Sewer _Septic Building Height:
C31IIlNER/LESSEE _ CONTRACT0R.
Name L. Name:Steven C Mears
Address: _ Company.Lifetime Exteriors
City: State: Address:102 South F St
Zip Code: Fax: _ City: Lake Worth State:FI
Phone No. � -� �-� � Zip Code: 33460 Fax: 561-582-7505
E-Mail: Phone N0561-533-8700
Fill in fee simple Title Holder on next page(if different. E-Mail Diane@Lifetimeexteriors.net
from the Owner listed above) State or County License CGC1 529442
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 Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW,INFORMATI N:
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 attorney before commencing work or recording our Notice of Commencement.
Ao� r
Signature of Owner essee Contractor Agent for Owner Signature of Contra ctor/Li9Kse Holder
STATE OF FLORID' STATE OF FLORIDA
COUNTY OF � �� �� COUNTY OF �� �J'��� Cl f'
S,wgrn to(or affirmed)and subscribed before me of SHro., to(or affirmed)and subscribed before me of
XX P ysical Presenyye or Online Notarization X sical Presence or Online Notarization
this -day of V lIAl9_— ,202/by this day of 202J by
vt- 644,3-JOS67
Name of person making statem t. Name of person making statement.
Perso Ily Kn n R Prod a Identification Person Kno n Produ d I entification
Ty p of Ident' icati Type Identi cation
Pr duced Pro uced
t
Y'p JOHNMICHAELFERRICK JpHNMICHAELFERRICK
as �a; �i: cr�ro rida ��
(Signs re of Not Public-Sat;d� lo!jda)Commissioni*GG120418 � gna re of Not y Pubctcy to e� '_Ideffiyju c- tateo NO
I :* '_o? My Comm.Expires Aug 26,202 �;._- Cominloon GG 120418
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Co . fission No. (Sell) e � mission No "'r l ry
J 6cnd �r �ANationalNota Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.