HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ��
Date: W<20-21 9' / Permit Number: (/ O
RECEIVED
AUG,3 0 2021
-Building Permit Application St, Lucie County
Permitting
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 CBDG' Funding
PERMIT APPLICATION FOR: _
PROPOSED�IMPROVEMENT LOCATION:.,
Address: 3803-Avenue L. Fort Pierce FL 34947
Property Tax ID #: 2405-601-0586 000/5 Lot No. ° _�5
Site Plan Name: Block No. 39-
Project Name:
DETAILED DESCRIPTION' OF WORK-
7 Accordion shutters in beige'color
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 X Shutters _ Windows/Doors _ Pond
7.
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 2.350.00 Utilities: —Sewer _ Septic Building Height: 15 ft
OWNERAESSEE:
CONTRACTOR:
Qe `'`""
Name Betty Williams
" '
Name: `-Juan Sosa
Address: 3803 Avenue L
Company;,Edwing's Unlimited Shutter Services, LLC
City: Fort Pierce
A_tldress:' P.Q. Box 881085
Zip Code: 34947 Fax:
City: Port Saint Lucie State: FL
Phone No. 7723322846
E-
Zip Code: 34988 Fax:
Phone No (772)340=0566
E-Mail edshutterservices@gmail.com
Mail:
Fill in fee simple Title Holder on next
page (if different
State or County License 3 211-H
from the Owner listed above)
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.
INFORMATION: _ :
•"
• ' A
DESIGNER/ENGINEER,:
� Not Applicable
MORTGAGE COMPANY:
iC
Not Applicable
Name:
Name:
Address: '•
Address:
City:
State:
City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
X Not Applicable
BONDING COMPANY:
iC
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 conflicts with any, applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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.
ev 2 2
SUP'PLENIENTAL CONSTRUCTION LIEN LAW
Signature of Own e Lessee/Contractor as Agent for Owner
STATE OF FLORID&� L � e.
COUNTY OF �
Sworn before v Physical Presence
Online Notarization
to (or affirmed) and su scribed me of or
this � day of ti 14 20�,,L, by •
..
Name of person making statement.
Personally Known OR Produced Identification
Typeof Identification �. L•
('Produced
�. cN, "I' ®f q ,.
(Signature of Notary Public- State of Florida),
Commission No. 6 6 75 9255 (Seal) :,oayrv�,, BLANCALSOSA
®; � Notary Public -State of Florida
%` Commission a GG 959255
,
- oi��• My Comm. Expires May 29, 2024
•Bonded through National Notary Assn.
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