HomeMy WebLinkAbout5401 Birch Drive Complete PermitDESIGNER/ENGINEER:
Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name:
Name:
Address:
City:
____State:
Address:
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 attorney before commencing work or recording your Notice of Commencement.
L - ���
Signa re of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF�-
Sworn to (or affirmed) and sub cribed before me ofPhysicalPresence or Online Notarization
this & day of 12024 by
iLi Cam.
Name of person making statement.
Personalty Known �� OR Produced Identification
Type of Identification Produced _ C
7ignature of N61ry P4A
..'KiARA S FIGUEROA
IPPY P� ii
Commission No. ?�� �¢;Notar)iC-State of Flori
Commission # HH 51970
M. 6� My Commission Expires
lor+October 08, 2024
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
All APPLICABLE INFO MI UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: l Permit Number:
4 bo t;. - Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-15S3 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: _61rc,11 Or 14
Property Tax ID #: J40 Z -- (o 0 Cl --Q I S�9 —DE)o Lot No.
Site Plan Name: -Rui a l OVA Block No.
Project Name:
DETAILED DESCRIPTION OF WORK: C'k0' (2 ac
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 _ Shutters - Windows/Doors — Pond
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ Isoo .60 Utilities: —Sewer _ Septic Building Height:
OWNERf LESSEE: I
CONTRACTOR:
Name niG (\19_ S v
Name:1`--,t-UL ,�,. tt'• _
Address: S4 0
City: State: State:
Zip Code: ?14q Fax:
Phone Sb L — L+O-Z.- Lz-r, I
Company: t -
Address:c`
City: ��� =%1 . t r State:
Zip Code: Fax:
Phone 1\101:t=
E-Mail, r 4,1 �; t�� -(4: _& ; 4;rpn:;tl�_
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Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County 6cen�e -
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.