HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number
� `-�
G • e -
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 5208 Sunset Blvd, Ft Pierce, FL 34982
Property Tax ID #:3402-608-0495-000-6 Lot No.
Site Plan Name: Block No.
Project Name: Mary Smith
I DETAILED DESCRIPTION OF WORK: I
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
1(a841
Additional work to be performed under this permit -check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters
_Electric _Plumbing _Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 28,997
_ Generator
Sq. Ft. of First Floor:
Windows/Doors _ Pond
Roof Pitch
Utilities: -Sewer Septic Building Height:
OWN ER/LESSEE:
CONTRACTOR:
NameNlary Smith
Name. Stephen Lambert
Address:5208 Sunset Blvd
Company: Newsouth Window Solutions
City: Ft Pierce State: FL
Zip Code: 34982 Fax:
Phone No.772-971-6593
Address:2526 Okeechobee Blvd.
City: West Palm Beach State:FL
Zip Code:33409 Fax:561-478-4100
Phone No 561-712-9000
E-Mail:
Fill in fee simple TttleHolder onnext page (if dlfferent
from the Owner listed above)
E-Mailpermits-wbp@newsouthwindow.com
State or County License SCC131151763
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.
SUMEMENTALCONMUCi' ON UEIN LAij1f
ATION: `
DESIGNER ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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 cerrifythat no work or installation has commenced priorto the issuance of a permit.
St. Lucie County makes no representation that is granting apermit 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 usesto another non-residential use
WARNING TO OWNER: Yourfallure 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 attornev before commencine work or recordine vour Notice oWommencpment.
Yl l CP
Sig�'aAu OwrIey Lessee/Contractor as Agent for Owner Signature of contractor/License Holder
STATE OF FLO STATE OF FLOR{q
COUNTY OF q`� �f] Pg[%1 COUNTY OF I�Y+� 1QCI� t
Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subsc ' d before me of
_CPhysical Presence or Online Notarization _ Physical Presence or Online Notarization
this 1:2�-day of OLAIna , 2021 by I this -L6,aay of � Cs�P , 202i by
Ma,, ,-1 C._7rIn A' I `fi� I [',"-)e 1+
Name of person Malking statement. Name of perlion making statement.
Personally Known OR Producedldentiflcation—zf I Personally KnownVl*�ORProduced Identification
Type of Identification ,, Type of Identification
(Signature of Notary ✓,ir.SMl
PH G. PEROTTI
(Signiture$f Notary Public- State of Florida )
N/�,MIve/'
State of1�10-�r1���ptla-Notary Pu4llc
Commission No. f
Comm1d5R4h N GG 186547
Commission No. , Publit Stine bt
Rr�S Dubien
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My Commission
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