HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: _24-
91T.
0
Building Permit, Ap'Plication
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 FORNEW HOME
Address: 6129 CARLTON RD PSL, FL 34987
Property Tax ID #: 3209-700-0008-000-5
Site Plan Name: MICHAEL SMITH %K0
Project Name: SMIH
BUILD SINGLE FAMILY RESIDENCE
New Electrical Meter Second Electrical Meter,
Lot No. 8
Block No.
Sr
U)
Additional work to be performed under this permit— check all that apply:
—Mechanical Gas Tank Gas Piping Shutters Windows/Doo'rs ' Pond
Electric Plumbing Sprinklers Generator Roof Nk
n: Sq t; F�I �qo/
Total —�S g6.7, =7,tRdQ Ft. 60E.-RIffs— o e�tic Building Height:
Cost of Construction:$ 1(601066
OVI/NERLESSEE7CONTRACTORS
rr
Name MICHAEL SMITH
Name: N/A OWNER BUILDER
Address: 390 LOTT ST
Company:
City. FT PIERCE State:
Address:
Zip Code: 34947 Fax:
City: , State:
Phone No. 772-370-3234
Zip Code: Fax:
E-Mail: nancyjoe20l6@yahoo.com
Phone No
Fill in fee simple Title Holder on next page (if different
E-Mail
from the Owner listed above)
State or County License
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. -
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 attorneybefore commencingwork or recordingour Notice of Commencement.
+i
SUPPLEMENTAL CONSTRl1CT14N LIEN LAW INFORMATION:.
-
DESIGNER/ENGINEER: _Not
Name: SCHULTZ,BITTLE,BSTODDARD,LLC
Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
X Not Applicable
State:
Address: '17171NDIANRIVERBLVDSUITE201
City: VERO BEACH State: FL
Zip: szsso Phone nz-no-sszz
FEE SIMPLE TITLE HOLDER: X
Name: SEE WARRANTY DEED
Not Applicable
BONDING COMPANY:
Name:
x Not Applicable
Address:
Address:
City:
Zip: Phone:
City:
Zip: Phone:
Signature of Owner/ lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF STLUCIE
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
_Physical Presence or Online Notarization
this � day of 202A by
this day of 2020 by
MICHAEL SMITH
Name of person making statement.
Name of person making statement.
�
Personally Known OR Produced Identification'
Personally Known OR Produced Identification
Type of Identification .
Type of Identification
Produced
Produced
(Signat r
(Signature of Notary Public- State of Florida)
Notary Publiee State of Florido
Commissi .N NANCYMIMSARMSTOaI)
Commission No. (Seal)
y-Eartirtria» OCi 91WY
xpires E00Ht3/2023
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