HomeMy WebLinkAbout5307 Birch Dr- Permit App.All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
° 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 CBDG Funding
PERMIT APPLICATION FOR:
x
I PROPOSED IMPROVEMENT LOCATION: I
Address: b 1 2a l-, AN
Property Tax ID #: { b 2 - 6�2O ' (� 91 r r OCC�<n Lot No. )
Site Plan Name: __L_V'J,'a. - rc �ST�iC`{ S _ Block No.
Project Name:1rMC7b�-
DETAILED DESCRIPTION OF WORK: n
1 a-, eL_o STwe > zz_e— Fe w L L4A_fCJS
r for r l ,• e- CA -
LA � + New Electrical Meter Second Electrical Meter (Affidavit required) �G
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit - check all that apply:
_Mechanical _ Gas Tank _ Gas Piping T Shutters Windows/Doors Pond
Electric _ Plumbing _ Sprinklers _ Generator X Roof Pitch
Total Sq. Ft of Construction: z Sq. Ft. of First Floor: t Z (� <�
Cost of Construction: $ SP Utilities: _ Sewer _ Septic Building Height: I `�
OWNER/LESSEE:
CONTRACTOR:
Name 0_-akC'0
Name: `Q-�-LGt cl coo
Address: 3zC_o Sc E )ter
Company: t2j Co
City: tti-_� " _ State: FL
Zip Code: 55) '� 5 Fax:
Phone No. :!PC !9 ` E-
Address: 02 7'1 42�•�
City: N r, (-- State: 42, C
Zip Code: i3 (" __ Fax:
Phone NoC-
Mail: P-AY-At or 4' iakv- farroc> Co
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail I'Ul it d� •/� C'®
State or County License 2&l? /&2�W(
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.
DESIGNER/ENGINEER: _
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone
Stater
City:
Zip: Phone:
State: _
FEE SIMPLE�jTLE
Name:
HOLDER: _
L� eu� eb lei..,.
Not Applicable
1. r
BONDING COMPANY:
Name:
_Not Applicable
Address: V w IQ
7"/
Address:
City:
City:
Zip: 37� Phone: °7 9.
- -34 / -% 92(.
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 attocney before commencing work or recording your Notice of Commencement.
Signature of O vner/ Lessee/Contracf6r astAgent for Owner
STATE OF FLORIDA
COUNTY OF/'�01I&iA.
Sworn for affirme ) and su scribed before me ofhysical Presence or _Online Notarization
this � day of J 201, ( by
r
nt.
Name of person m2=Producecl
Personally Known Identification
Type of Identification Produce
Signat r„o- u lic-State of Florida)
Lawrence R. Castro
Commissi otar ,ub6c (Seal)
a StateoPFlorlda
Ida
a Comm#FI
73
E 1 Expires 10/14/2024
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DATE
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COMPLETED
Rev 5/20/21