HomeMy WebLinkAboutHEALY BuildingPermitApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34952
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: HEALY, CAROL
PROPOSED IMPROVEMENT LOCATION:
X
Address: 6223 ARLINGTON WAY, FORT PIERCE 34951
Property Tax ID #: 154534 Lot No.177
Site Plan Name: HEALY Block No.
Project Name: HEALY
DETAILED DESCRIPTION OF WORK:
INSTALL 6.8 ACCORDION STORM SHUTTERS ON (4) 2nd FLOOR OPENINGS OF HOME.
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank —Gas Piping TShutters T Windows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 2245.00
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name CAROL HEALY
Name: DAVID MILLER
Address: 6223 ARLING'TON WAY
Company: A QUALITY CONSTRUCTION LLC
City: FORT PIERCE State: FL
Zip Code: 34951 Fax:
Phone No. 321-751-5419 E-
Address: 3531 S 25TH STREET
City: FORT PIERCE State: FL
Zip Code: 34981 Fax:
Phone No 772-489-2464
Mail: SAME
Fill in fee simple Title Holder on next page (if different
from the owner listed above)
E-Mail lave@agualityconstructionllc.com
State or County License CBC1257739 / CC131150762
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
bylaws
which is in conflict with any applicable Home Owners Association rules, 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 corded in the public records of St.
Lucie County and sted on the jobsite before the first inspection. If y,6u intend to obtain financing, consult
with lender or 4KAttorney before commencing work or recording r Notice of Commencement.
Signat Owner ee/Contracto s Agent for Owner
nat of Con actor/License Holder
S;ATE
STA E OF FLORIDA
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S OF FLORIDA . .
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COUNTY OF 1 �
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
L% Physical Presence or Online Notarization
✓ Physical Presence or Online Notarization
this ;?_6 day of 202( by
this day onf� 20Z/ by
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Name of person making statement.
Name of person making statement.
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Personally Known OR Produced Identification
Type of Identification
Type of Identification
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Signature of Notary Publi a
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Commission No
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 5/6/20