HomeMy WebLinkAboutBuilding Permit App - Signed by Contractor All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
LA Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential YES
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 CBDG Funding
PERMIT APPLICATION FOR: James Hardie Siding
PROPOSED IMPROVEMENT LOCATION:
Address: 379 SE GASPARILLA DRIVE PORT ST LUCIE FL 34983
Property Tax ID#: 3419-530-0149-000-9 Lot No.21
Site Plan Name: 28/36S/40E Block No. 37
Project Name: BERRY - SIDING
DETAILED DESCRIPTION OF WORK:
Install James Hardie Siding & Trim
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: $ 8,209 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name BARBARA A BERRY Name: MICHAEL G HOLEMAN
Address: 379 SE GASPARILLA DRIVE Company: HOLEMAN INC
City: PORT ST LUCIE State: FL Address: 212 N US HWY 1 #17
Zip Code: 34983 Fax: City:TEQUESTA State: FL
Phone No. 954 253 1627 E- Zip Code: 33469 Fax:
Mail: BARBARA-BERRY@COMCAST.COM Phone No 561 743 0687
Fill in fee simple Title Holder on next page (if different E-Mail PERMITS@HOLEMANINC.COM
from the Owner listed above) State or County License CBC1250217
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
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 or recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA 1
COUNTY OF P(3,\m ei,-ea� /
V
Sworn to(or affirmed)and ubscri ed before me of Physical Presence or Online Notarization
this A2)-day of ,202-( by
Name of person making statement.
Personally Known OR Produced Identification
Type of I n 'fication P ed (�
(SignkZ re of Notary Publiicac-State of Florida) o�p LESLIE FLETCHER
�p6 lC r� e NOTARY PUBLIC
Commission No. (Seal) -•STATE OF FLORIDA
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Col GG193476
. E Expires 5/14/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev12-0121