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Home My WebLink AboutPermit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: S LU LLL ry �� J j J Building Permit Application Planning and Development Services / Building and Code Regulation Division Commercial Residential ✓ 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: PROPOSED 111/Ilit 1i"� �,`�^ �,. Address: 6512 Doris DR Fort Pierce, FL 34951 Property Tax ID #: 1301-610-0095-000-2 Site Plan Name: Project Name: Charles Dickinson New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: Lot No. 25 Block No. 5 Additional work to be performed under this permit — check all that apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters lOWindows/Doors _ Pond Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: ~act Cost of Construction: $ 3q � q� • Utilities: —Sewer _ Septic Building Height: Fk_ r. OWNER%LE � `�� sf;, }NTRACTOR: Name Charles Dickinson Name: Scott Berman Address: 6512 Doris DR Company: Florida Window & Door City: Fort Pierce State: _ Zip Code: 34951 Fax: Phone No. (860) 262-3289 Address: 1125 N Dixie Highway City: Lake Worth State. FL Zip Code: 33460 Fax: Phone No 561-340-4300 E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail howard@floridawindowanddoor.com State or County License 28576 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. SUPPLEM ENTAL C©NSTf�UTIC�� DESIGNER/ENGINEER: _ Not Applicable pp 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 is in conflict with arty 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 Comm Ing work or recording your Notice of Commencement. Sig Ore of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA COUNTY '�yy�'�j,�o`G1� STATE OF FLORIDA OF_ COUNTY OF Palm Beach Sworn to (or affirmed) and subscribed before me of Physical Presence Online Sworn to (or affirmed) and subscribed before me of or Notarization this t, day of CjG`'a%Pi✓" 2020 by lio Physical Presence or Online Notarization this --&- day of Oc-Q—,,� , 2020 by Charles Dickinson Scott Berman Name of person making statement. Name of person making statement. Personally Known OR Produced Identification 'X0 Personally Known x OR Produced Identification Type of Identification Produced L • n ww ✓t&�10�� j�Ess ///� Type of Identification Produced ' OIAMISS/p ' ; i \'.fdANESS,q rN ss . 'p ' r wee re of 46tary Pu'1 - State of.�I* a) y P��fl (Signature o Nota'rj ublic- State of Floridaf _ Commission No. la )66 - kSe�.a1 f)Z1� �* Sy ' ommission No. Iy �21�,�(sue• *"'�i� •�o 1 aiOa?aed lhN • 0 ' ; e�Ish9 REVIEWS FRONT ''� ��c ZONING'//ij' '' •'' oP ,`� Q y�� PLANS VEGETATION SEA TURTLE Sra� M�IVjj�{r1;1�� COUNTER REVIEW u�W�W�R REVIEW REVIEW REVIEW REVIEW DATE 1 RECEIVED DATE COMPLETED ev.