HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
OPOSED,IMPA.OVE
Address: 147 SE SOLAZ AVENUE, PORT SAINT LUCIE FL 34953
Property Tax ID B: 3419-540-0256-000-3
Lot No. 33
Site Plan Name: RESIDENTIAL
Block No 50
Project Name:
DETAf ,
CHANGEOUT FRONT DOOR -NO SIZE CHANGE
New Electrical Meter Second Electrical Meter
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: Sq. Ft. of First Floor:
Cost of Construction:$ 3,036.17 Utilities: _Sewer _Septic Building Height:
Name RON REIS Name: AAMED D.DAVIS
Address: 4412 SW PALEY RD Company: JSG CARPENTRY INC
City: PORT SAINT LUCIE State: In Address: 13461 79TH CT N
Zip Code: 34953 Fax: City: WEST PALM BEACH
State: FL
Phone No. 954 662 8268 Zip Code: 33412 Fax:
E-Mail: Phone No 561-855-4052
Fill in fee simple Title Holder on next page ( if different E-Mail
from the Owner listed above) State or County License CGC 022831
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.
'711", f' 0
DESIGNER/ENGINEER:
Name:
x Not Applicable
MORTGAGE COMPANY:
Name:
x Not Applicable
Address:
Address:
City:
Zip: Phone
State:_
City:
Zip: Phone:
State:_
FEE SIMPLE TITLE HOLDER:
Name:
x Not Applicable
BONDING COMPANY:
Name:
x Not Applicable
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.
1 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 ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylawsnnr an covenantsthat may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed or 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 Lurie 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 OWNER: your failure to Record a Notice of Commencement may result in paying twice for
improve nts to your roperty. A Notice of Commencement must be recorded in the public records of St.
Lucie Cou ty and p Is on the jobsite before the first inspection. If you intend to obtain financing, consult
with le 1 r or an at rn v before commencing work or recording our Notice of Commencement.
Signatude of Owner/ Lessee/Contras or as Agent for Owner
Signature of Cona r/License Holder
STATE OF FLORlQA
STATE OF FLORIDA
P�eG
COUNTYOF \�.`
COUNTYOF9hIm Cz_
Swor to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Phsical Presence or Online Notarization
✓ Physical Presence or Online Notarization
this!"day of 7, 'lS*2aB2r by
this i,-day of nuOuSb .2010Iby
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Name of person making statement.
Name of person making statement.
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Personally Known OR Produced Identification `�
Personally Known " OR Produced Identification_
Type of Identification
Type of Identification
Pr ced .f-t:nL
Produced
ISIgotumd of N&tary Pudic- S
(Signa m of Notary Pub SWL.KFIoyW2VGEIAYiJiJNiJ
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Commission No. GC�4164 sf5p NIAION-GG9/1663
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VEGETATION
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REVIEW
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DATE
RECEIVED
DATE
COMPLETED
ev.
FLORIDA JURAT
FS 117.05(13) — Effective January 1, 2020
State of Florida
Count' of PAI M BFACH
Sworn to (or affirmed) and subscribed before me by
means of
W Physical Presence,
—OR—
❑ Online Notarization,
this \ LD dayof nC CsU 3t Goal by
Dal' Month year
JAMES Q. DAVIS
Nome 0fPen an Swearing orAfllrming
Signature o1lgDerry Pub y —State of Florida
ANGEI A YOUNG
Name of Notary Typed, Printed Or Stamped
A`"+ouasf ANGEUYOUNG X Personally Known
Commission# GG 968864
Expires April 12,2024 ❑ Produced Identification
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