HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: Y�
o ILUXURI;Z_'�_�o U �rAm ivs
s 3 Building Permit Application
Planning and Development Services SUN ® 202f
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue,Fort Pierce FL 34982 .9
Phone:(772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR:
if 6
POSED
;IM PR OVEMENT LOCATION s.
Address:
Property Tax ID#: i015L Lot No.
Site Plan Name: Block No.
Project Name:
f7ETAILED DESCRIPTION OF WORK
New Electrical Meter Second Electrical Meter
CONSTRUCTION:i NFORMATION k
Additional work to be performed under this permit—check all thatt pply:
_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:$ Utilities: _Sewer _Septic Building Height:
01%VNERhES5EE = CONTRACTOR
_ _ .
Name Name:Steven C Mears
Address: Company:Lifetime Exteriors
City: State:K, Address:102 South F St
Zip Code: -13Y 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 CGC1529442
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.
I —
SUPPLEMENTAL CONSTRUCTI0N'LLEN-,.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 attorney before commencing work or recording our Notice of Commencement.
Signature of Owner/Less a/Contractor as Agen—tk2f_04ner Signature of Contra or/License H-3rder
STATE OF FLORIDA-) Q STATE OF FLORIDA
COUNTY OF la/ � ada COUNTY OF w
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
deal Presegnce or Online Notarization k Ph sical Presence or Online Notarization
this day ofVIIAJL� 202/by this fi day of `1111VdP' ,202d by
Vu�
Name of p on making state nt. Name of person making state n
Per Wally K own OR Pro uced Identification_ Perso y Kn n OR Pr uced Identification
T e of Ide tificati n Ty of[den ficat' n
roduced L P duced
Ut
_ .�
(Sign ure of N ary ublic=e5Yte of� " - Sig
,�j ,��aH�eLFERRieK (Sig ture of tary Publi -State of Florida.
�'iY P
2�`'�,1L�` = Notary Public-Stateof'rlorida
CO , mission o. U* .' Comm Seal G120416 YP JOHNMICHAELFERRICK.
p C mmission 0. '9`?4 �p`�` N(t�'Efa�iic-State of Florida
f ' = "' ��, My Comm.Expires Aug 26,2021 �'' Commission x GG 120418
FOF °�' Bonded through National Notary Assn. `.0 Wr M Comm.EXpiresAug26,2021
�. ..„F:: y I
Bondedl .Ughi
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION EATT MANGROVE 0
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED.
DATE
COMPLETED
ev.