HomeMy WebLinkAboutbuilding pemitAll APPLICABLE INFO MIU:
Date: 11 /18/2021
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Planning and Development
Building and Code Regulati,
2300 Virginia Avenue, Fort,
Phone: (772) 462-1553 F
BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Building Permit Application
rvices
Division Commercial YES Residential
rce FL 34982
(772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 5405 TURN PIKE FEEDER ROAD
Property Tax ID #: J_Jr�_
Site Plan Name:
Project Name: CHURCH
DETAILED DESCRIPTION OF WORK.
New Electrical MeterSecond Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be perfon
XMechanical Ga
_ Electric Plui
Total Sq. Ft of Construction:
Cost of Construction: $ 700C
OWNER/LESSEE:
NameLakewood Park Uni
Address: PO BOX 651278
City:VERO BEACH
Zip Code: 32965 _ F�
Phone No.
Mail:
Fill in fee simple Title Holder
from the Owner listed above
Lot No.
Block No.
(Affidavit required)
ed under this permit —check all that apply:
Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
bing _ Sprinklers _ Generator Roof
— Pitrh
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic
I Methodist Church
StateFL
next page (if different
CONTRACTOR:
Building Height:
NameJames E Dupuis
_ Company: Jimmy's A/C & Refrigeration
Address: 46 43RD CT
City: Vero Beach State: FL
E- Zip Code: 32968 —Fax: 772-299-3184
Phone No 772-562-8353
E-Mail_ INFO(a)JIMMYSAIR COM
State or County License QAC18148 1
If value of construction is 2500 o more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or mo e, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEE'R: — Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address: —
City: State: City:
Zip: PhoneState:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phon : Zip: Phone:
OWNER/ CONTRACTOR FFIDVIT: 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 repr sentation that is granting a permit will authorize the permit holder to build the subject structure
which conflicts with any apple : ble Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with our 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 you 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.
nature of Owner/ Lessee/C ntractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF INnIAM RIW i=Q
Sworn to (or affirmed) and suliscribed before me of X Physical Presence or Online Notarization
this 18 day of NOVEMVER , 20 21 by
Name of person making state
Personal) Known X
Y OR Produced Identification
Type of Ids tifica 'on Produce
P(Signat re f Notar blic- St 3te of Florida)
ti
Commission No ,3 2 �`"`kc Notary Public State of Florida(Seal) Rebecca Feeley
My Commission HH 083257
Of � ' Expires 03/0E/2025
REVIEWS I FRONT 11 NING
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DATE
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