HomeMy WebLinkAboutBUILDING PERMIT APPLICATION s° --
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 09/27/2021 Permit.Number:
1q)To[Luals
p ° Building Permit Application
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: 4101 S Indian River Drive, Fort Pierce, FL 34982
Property Tax ID#: 2435-111-000"00-1 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Remove two exisfing garage doors. Install two new garage doors.
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 X Windows/Doors Pond
_Electric. _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ 2;350 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Thor Welhaven Name: Homeowner -Thor Welhaven
Address: 4101 S Indian River Drive company:.NIA
city: Fort Pierce State: FL Address: 4101 S Indian River Drive
Zip Code: 34982 Fax: (772)461-2170 city: Fort Pierce State: FL
Phone No. (772)370-4624 E- Zip Code: 34982 Fax: (772)461-2170
mail:.thorwelhaven@bellsouth.net Phone No (772)370-4624
Fill in fee simple Title Holder on next page(if different E-Mail thorwelhaven@bellsouth.net
from the Owner listed above) State or County License NIA
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: 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: 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 attorney before commencing work nr recording your Notice of Commencement.
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Signature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF S}-, L
Sworn to(or affirmed)and subscribed before me of Physical Presence or Online Notarization
this X�day of f5j., 2QI by
N-f Q I d,a_v�_r,
Name of person making statement. '
Personally Known ✓ OR Produced Identification,
Tyl a of Identification Produced (�
(Signature No a Pu r -State of Flor' )
Commission No. .V" N4�b],b1,C State of Florida
f Y't Dorothy W Hernandez
`a. My Commission HH 007299
Expires 09/17/2024
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE .
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DATE
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