HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a+1 Permit Number:
'` RECEIVED
Building Permit Application JUL 2 7 2021
Planning and Development Services St.Lucie County
ry
Building and Code Regulation Division Commercial Residential XXX
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
PROPQ;SED IMPROVEMENT LOCATION,
Address: 1007 Buckeye Dr., Fort Pierce, FI
Property Tax I D#: 3404-501-05440002 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED�ESCRlPTION :OF�V�RK ,,
pis
and OV4pkeoe metal roofing system and remove torchdown and install
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION„INFO'RMATION ;
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 X Roof Pitch
Total Sq. Ft of Construction: 2 Sq. Ft.of First Floor: 3�;_Q
Cost of Construction:$ Utilities: —Sewer —Septic Building Height:
01rUNER/LESSEE CON RAC R—
Name Stephen Dornfeld Name: Richard Newland
Address: 1007 Buckeye Dr.. Company: Richie the Roofer Inc.
City: Fort Pierce, A State:FI Address: 903-13.th SW
Zip Code: 34982 Fax: City: Vero Beach, FI State:FI
Phone No. Zip Code: Fax:
E-Mail: Phone No 772-473-6197
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License CCC058021
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 IN:F,:ORMATION
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.
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.
ature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORID
COUNTY OF a L 0
Swor. two(or affir d)and subscribed befo a me of Physical Presence or Online Notarization
s ! ''thiaay of I 1 0 1 A 2( by
Name of person making state ent.
Personally Known OR Produced Identification
Type of Ident' 1 ation Produced
.-6-4 _L2 ,
(Signature of Notary Public-State of Florida}
Commission N `Q (Seal) ra?
vPr4 Notary Public State of Florida
Amanda P Sanderson
a My commission GG 211256
OF IV Expires 0412512022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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