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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: ' PROPOSED IMPROVEMENT LOCATION: Address: 911 JACKSON WAY, FT PIERCE, FL 34949 Property Tax ID #: 1423-802-0023-000-1 Site Plan Name: Project Name: DETAILED DESCRIPTION OF WORK: �- New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: Residential X Lot No.21 Block No. 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: $ OWNER/LESSEE: NameALBERT & STEPHANY POWERS Address:132 MUNSONVILLE RD Sq. Ft. of First Floor: Utilities: —Sewer _Septic Building Height: City: GLOVERSVILLE State: Zip Code: 12078 Fax: Phone No.518-337-1532 E-Mail: SPOWERS12@NYCAP.RR.COM Fill in fee simple Title Holder on next page ( if different from the Owner listed above) CONTRACTOR: Name:JOY S YANCY Company:SUMMERLIN'S MARINE CONSTRUCTION, LLC Address:200 NACO RD, # C City: FT PIERCE State: FL Zip Code: 34946 Fax: 772-464-7470 Phone N0772-464-6090 E-Mail SUMMERLINSMARINECONSTRUCTION@GMAIL.COM 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 Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable En3in-e-Q-r Ll-r- Not Applicable Name: Chr'C�(Lck- C- r-\chin-P 4-'(in C\ Name:" i --Ti d-e_ Address:_ pt~o Ca d gLs,Llr -& r-\V Address: 3eYit City: �4 - Pi -Q d'C-e' State: FL City: i e C-e- State: t=i. Zip:'3y SO Phone`-T7a •Q1�Tj - i3 � Zip:. Phone: • 14L;. i - A Ql�C7 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. (XV, L Signature of Owner/ Lessee/Contractor as Agent for Owner Signatur f Contract r/ icense Hold STATE OF FLORIDA STATE FLORIDA COUNTY OF S L . LU_ C-i COUNTY OFFS�-- . L_ 4 6-0— Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of X Physical Presence or Online Notarization X Physical Presence or Online Notarization this 28 day of APRIL 2024 by this 28 day of APRIL 202t by 3 jt' ©L j S JOY S YANCY Name of person making state ent. Name of person makin statement. Personally Known OR Produced Identification x Personally Known x OR Produced Identification Type of Identification L Type of Identification Produced Ili Produced , (Signature of Nckhry Public- State of Florida) (Signature of NQary Public- State of Florida )` Commission No. GG3302 gal Notary ubtic late of Florida Commission No. GG330259 Pa N Fu is State of Florida Ginger P. Hester Ginger P Hester GG 59 Expires 08/25 023 4 Expires /25/2023 REVIEWS FR PLANS VEGETATION COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED iev.5/6/20