HomeMy WebLinkAboutBuildig Permit Application• Lc r
I A PLICABLE INFO MUST -BE COMPED FOR APPLICATION TO BE ACCEPTED ,,ll `� �1
D e: 11/10/2020 Permit Number: � o t 1 `` O NWO/
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LUC E
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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
9
PERMIT APPLICATION FOR: Duane Bowman
PROPOSED IMPROVEMENT LOCATION ti
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Address: 6505 Ft. Walton Ave
Property Tax ID#: 1301-612-0098-000-9
Site Plan Name: Lakewood Park -unit 10
Project Name: Bowman's7resident
Cabinets, Bathroom fixtures, Drywall Ceilings and a few walls, and attic a/c.duct.
New Electrical Meter
Second Electrical Meter
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Additional work to be, performed under this.permit— check all that apply;
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
VElectric XPlumbing _ Sprinklers _ Generator _ Roof
Total Sq. Ft of Construction: 600 sf Sq. Ft. of First Floor.:
Cost of Construction: Utilities: —Sewer _Septic
Lot No. 18
Block No. 122
Building Height:
Pond
Pitch
OWNER/LESSEE s �
CONTRACTOR
Name Duane Bowman
Name:Owner/Builder XNA
Address:6505 Ft. Walton Ave
Company:
City: State:
y Ft. Pierce, FI _
f ` Address:
Zip Code: 34951 Fax:
City: State:
i
Phone No.772-577-9368
Zip Code: Fax:
Phone No
E-Mail: bowmandc36@gmail.com
Fill in fee simple Title Holder on next page ( if different
E-Mail
from the Owner listed above)
State or County License
If value of construction is 2500 or more, a RECORDED Notice of commencement is requires.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
=SUPPIEMEN'CA�.C�NSTR�UCTI,ON
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DESIGNER/ENGINEER:
— Not Applicable
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 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.
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 ins action If ou intend t bt . f' I
p . y o o aln Inancing, consu t
with lender or an attorney before commencing work or recording our Notice of Commencement.
Lgnatu
a of O e ssee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Physical Presence or Online Notarization
this _LQlay of rt9 2020 by
this day of , 2020 by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identificati
Produced_r ��
Type of Identification
Produced
(Signature of Notary Pub ' - State of Florida)
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
Commission No. (Seal)
\\�PpY P � i ELLEN VAUGHN
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REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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