HomeMy WebLinkAboutBuilding Permit APP, page 2All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
S�I . U1LI-1 L1S
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> 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:
PROPOSED IMPROVEMENT LOCATION:
Address: 4807 Barcelona Ave. Fort Pierce, FL 34946
Property Tax ID #: 141-703-0164-000-2 Lot No.
Site Plan Name: Block No. H
Project Name: Tillman - 11117012
DETAILED DESCRIPTIONOF WORK:
Replace 5 windows size for size—iw.eA(,t-
New Electrical Meter Second Electrical Meter (Affidavit required)
CCINSTRUCTION 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: $ 9528.00 Utilities: —Sewer —Septic Building Height:
%INNER/LESSEE:
CONTRACTOR:
Name Irene Tillman
Name: Arthur Francis
Address: 4807 Barcelona Ave.
Company: The Home Depot
City: Fort Pierce State: FL
Zip Code: 34946 Fax:
Phone No. E-
Mail:
Address: 2455 Paces Ferry Rd. C11
City: Atlanta State. GA
Zip Code: 33039 Fax:
Phone No 407-768-3357
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail robertosanchezthd@expeditepermit.com
State or County License CGC1255717
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: _
Address:
City:
Zip:
Phon
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name:
State
Not Applicable
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name: _
Address:
City:
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 attornev before commencing work or recording vour Notice of Commencement.
00-01,
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF 41 1,�,tttQ�
Sworn to (or affirmed) s4bscribed before me of T Physical Presence or Online Notarization
^an'd
this � day of A) 6 20Sk by
/Cb-tc4 CSa
Name of person making statement.
Personally Known OR Produced Identification
T entifica ' n uced
(" natur of ubIic- lorida)
JONATHON THOMAS
Commission No. (Seal)
+ WCOMMISSION#HH144714
EXPIRES: September 10, 2025
,r t4�' Bonded Thm Not�y Public Undew ten
REVIEWS
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ZONING
SUPERVISOR
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SEA TURTLE
MANGROVE
COUNTER
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DATE
RECEIVED
DATE
COMPLETED
Rev 5/20/21