HomeMy WebLinkAboutBUILDING PERMIT APPLICATION ` D�alaoarors
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
1 Permit Number:a`\OA-6o`
`� a.
�40���➢� � RECEIVED
o ;- AUG 0 2 2021
Building Permit Application St.Lucie gounty
Planning and Development Services 1— Permitting
Building and Code Regulation Division Commercial /Cl Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR: S
PROPOSED IMPROVEMENT LOCATION:
Address: 3100 N Highway Al-Unit 404
Property Tax ID#: 1425-606-0008-000-4 Lot No.
Site Plan Name: Block No.
Project Name: Gory Residence
DETAILED DESCRIPTION.OF WORK:
INSTALL ACCORDION SHUTTERS- oZ
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit=check all that apply:
_Mechanical _Gas Tank —Gas Piping utters _Windows/Doors _Pond
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ 13,000 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: ' CONTRACTOR:
Name STEVE P GORY Name: EDWARD J HERITAGE
Address:3100.N.HIGHWAY MA UNIT 404 Company:;FQLD,ING4SHlJ.TTER CORPORATION
City: FOFiT'PIERCE State:_ Address:_1862 DR'MARTIN'LUTHER KING BLVD
Zip Code 34949 f ,Fax:N/A City.:,,WEST PALM�BEA�H,.' State:FL
Phone No.305-746-0084 Zip Code: 33404 Fax: 561-640-8204
E-Mail:SPG2944@GMAIL.COM Phone No 561-683-4811
Fill in fee simple Title Holder on next page(if different E-Mail INFO@FOLDINGSHUTTERS.COM
from the Owner listed above) State or County License SCC131151041
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 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 C actor as Agent for Owner Signature of actor/License Ider
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF PALM BEACH COUNTY OF PALM BEACH
Swor o(or affirmed)and subscribed before me of Sw.o pto(or affirmed)and subscribed before me of
P ysical Presence or Online Notarization V Physical Presence o Online Notarization
thise�day of ,j y +1 20�by this a`day of �Ji`1 2021T by
EDWARD J HERITAGE EDWARD J HERITAGE
Name of person making statement. Name of person making statement.
Personally Known xxxx OR Produced Identification Personally Known xxxx OR Produced Identification
Type Type
Identification of Identification
P duc o- Pr ucec
(Signature of Notary Public-&Stafpa A.Evans (Signature of Notary Public-StO of FIp A.Evans
NOTARY PUBLIC NOTARYPUBLIC
Commission No. W/ OF FLORIDA Commission No. FLORIDA
Comm GG262789 y Comm GGM789
Expires
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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