HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �1 a1 Permit Number:
RECEIVED
4:
�$ g ~ Building Permit Application AsUG o�2021
ilMy
Planning and Development Services ~ Permifhii�,
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.IMPRO.V,EMENT,LOCATION: `
Address: Curt Ohm
PropertyTax I D #: 1301-603-0202-010-7
Site Plan Name:
Project Name: Ohm Residence
Lot No. 26
Block No. 23
(.DETAILED DESCRIPTION -OF WORK: °I
New Electrical Meter
Second Electrical Meter.
CONSTRUCTION I',NFORMATION:
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 -V Roof Pitch
Total Sq. Ft of Construction: �5�� Sq. Ft. of First Floor:
Cost of Construction: $ 20,000 Utilities: —Sewer _Septic
Building Height:
.,.OWNER/LESSEE:, , .
CO.NTRACTOR..
Name Curt ohm
Name: Calvin Lars Christensen
Address: 5302 E Seminole Rd
Company: Roof Doctors LLC
City: Fort Pierce State: FL
Address: P.O. Box 467
Zip Code: 34951 Fax:
city: Jensen Beach State: FL
Phone No. (713) 816-9838
Zip Code: 34958 .Fax:
E-Mail:
Phone No 800-339-7326
Fill in fee simple Title Holder on next page Of different
E-Mail Roofdoctorsfl@gmaii.com
from the Owner listed above)
State or County License CCC1326620
If value of construction is 2500 or more, a RECORDED Notice of Commencement is requirea.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION„LIEN LAW�INFQRMATIO.N ,
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 attornev before commencing work or recording vour Notice of Commencement.
-.4
n
Signature o Owne essee/ ont r as Agent for Owner
Signature of Contractor/License Hol r
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF MQJ 11
COUNTY OF Martin
Sw9pn to (or affirmed) and subscribed before m
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notariz igR;s
_,hysical Presence or Online Notarization
This day of 2�20 by
P'
this day of AAAqIA72SIT 2928-by
_t
Calvin Lars Christensen
Name of person making statement.
>
Name of person making statement.
/
03
Personally Known V OR Produced Identi
#@M. - D
Personally Known OR Produced Identification
Type of Identification
; N• = D
CO
Type of Identification `\\�pYP ��� AMANDA M EEHAN
Pr duc �e�'-
Pro uced
( U �
o g m m
�'�`� tary Public -State of Flori
Commission # GG 29940
wmn,
My Commission Expires
( ignature of ry Public- State of Florida)
�' A o D
(Signature of Notary Public-
�, o,•Z
�n
Commission No. (Seal)
"
Commission No. (Seal) 7
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