HomeMy WebLinkAboutPermit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
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Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 4624553 Fax: (772) 462-1578
Address: 1701 N 35th ST Fort Pierce, FL 34947
Property Tax ID #: 2405-601-0251-000-8
Site Plan Name:
Project Name: Earl S Gardner
New Electrical Meter
Second Electrical Meter
Additional work to be performed under this permit —check all that apply:
Electric
_Gas Tank
_Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ I
_Gas Piping
_Sprinklers
_Shutters
Generator
Sq. Ft, of First Floor:
Residential t�
Windows/Doors
_ Roof
Lot No.3-5
Block No. 14
_ Pond
Utilities: _Sewer _Septic Building Height:
71
Pitch
Q11UN�R
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:
Name:
_ Not
Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City:
Zip:
State:
Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE
Name:
HOLDER, Not
Applicable
BONDING COMPANY: Not Applicable
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.
Inconsideration 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 attornev before commencing work or recording vour Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORI
COUNTY OF m-,
Sworn o (or affirmed) and subscribed before me of
y al Pres or Online Notarization
thi y o 2021 by
EARL S GARDNER
Name of person n
Personally Known
MOR
f
(Signature
Commissi
REVI
statement.
OR Produced Identification
Public- State of Florida
KRISTINE HOPKINS
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF Fe�mBeaot,
Sw rn to (or affirmed) and subscribed before me of
✓ Physical Presence or Online N tarization
this la day of 14Q!qS A , 202f by
Scott Berman
Name of person making statement.
Personally Known X OR Produced Ide
Type of Identification
Produced
(Signature of Notary Public- State of Florida )
Commission
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