HomeMy WebLinkAboutBuilding Permit App - Pietrowiez All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
S:`ti LL! L-
04,
L
Building Permit Application
I
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:
PROPOSED IMPROVEMENT LOCATION:
Address: 1 1 M 1 1 1 v 2423 Tamarind Drive
Property Tax ID#: 1436-601-0038-000-2 Lot No. 17-18
Site Plan Name: Block No. 2
Project Name: ALEXANDRA'S RESIDENCE
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DETAILE&-DESC ION F W9,RK:
CHANGE OUT FRONT DOOR-NO SIZE CHANGE
New Electrical Meter Second Electrical Meter
FCONSTRUCTION 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:$ 2,342.53 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
. COI �"RACTOR:
Name ALEXANDRA PIETREWICZ Name:JAMES D.DAVIS
Address: 2423 TAMARIND DR Company: J&G CARPENTRY INC
City: Hutchinson Island State:J�L Address:13461 79TH CT N
Zip Code: 34949 Fax: City: WEST PALM BEACH State:FL
Phone No. 7722931437 Zip Code: 33412 Fax:
E-Mail: Phone No 561-855-4052
Fill in fee simple Title Holder on next page(if different E-Mail V e'cc'��Pparrmn I j t'bt al l•r 7r-r�
from the Owner listed above State or County License CGC 022831
If value of construction is 2SIDO or more,a RECORDED Notice❑f Commencement is required.
If value of HAVC is$7,5GO or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL C MATIO
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State:_ City: State:_
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x 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(yy makes no representation that is granting a permit will authorize the ennit holder to build the subject structure
which is in cangict with any applicable Home Owners Association rules,bylaws or antl 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:roan 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 1
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
,zwiith lenderoran attorneybefore commencingwork or recordingour Notice of Commencement.
Signature of Owner/Lessee/Contractor as tfor Owner Signature ofC actor/Ucense Holder
STATE OF FLORIDA !! STATE OF FLORIDA
COUNTY OF t. Ll'C COUNTY OF PAIM Srr N
Swor (or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
wl Pre se ce or Online Notarization Physical Presence r Online Notarization
this ay of 2828 by this day ofrCtn � .202g16y
d/� goal -
biifG•tt_G�tR, ,IWO Ull.GSY q
ame pe
Name of person making statement. Nrson making st ement.
Personally Known OR Produced Identification Personally Known ✓/ OR Produced Identification
Typ f Identifi ation Type of Identification
Mig �'J=
Produced /, yvroe. ANGEIAVOUNG
of 40 lllg aleI — (Signture of otwyB blk-State' floddar)1nun I Gu 5G9a64
CnRLn I COVLTEA .q�_'� a< Expires Annl 12.2024
Comm'. io o. `. ` nuary wo-,Space-,m Commission No. ' ,,.mee� s°"�g'aa'avnxourvsoms
Cammisrw*=GG=<1ut
Mvcamm.0xirooa Jo.2021
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
ROINDA AMUN
1-5 tt7.OSM—Elfaewre JaniuSry i,202o
State of Ronda
County or PALM RFACH
Swam�(or afyirrnetlj and 9rDsc+ibed before me oY
means of
®Phy%car Preaeree.
—OR—
'�;ONne Norarizeopl ma daYoflt�^r
+ALg.'r— , -)I by
DAMES ❑ DAVIS
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/mudufent n cnme o!on Ram m an urmNended doapwx
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1
'i trite or Type of Document
Document De@: Number Of Peaec
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S9na*OC Tnan Named Above:
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