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HomeMy WebLinkAboutBuiling Permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r� Date: Permit Number&01 pL 0100 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 IMPROVEMENT LOCATION: _ Address: If 0�eZ Qt alp., rrtfzC i rA eT— Property Tax ID#: 1414- 701 0031 - 600 Lot No. �. Site Plan Name: Q(AeeY►5 GoVe U/Ytt7 'I Block No. Project Name: UME94 '&A7'L c`!vT DETAILED DESCRIPTION OF WORK: ©cp Tzm�T 1,pr I'V ors'1 c New Electrical Meter Second Electrical Meter CONSTRUCTION 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: $ 900 Utilities: —Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name�Q�a� UJfa 93 MUne: r L-Liq Address: ompany 0 City: State:_ Address: q'l /4yookgy e Zip Code: 31111 Fax: City:3MAWn w State: Phone No. 1AI" yyV /7Sr Zip Code: ';PJ65( Fax: E-Mail: ,tea (;Fit®d 1• G/+w Phone No 77a-q73 —[ ' 37 Fill in fee simple Title Holder on next page( if different E-Mail �pi/L 0Q_kg A$4* J COMA from the Owner listed above) State or County License e,— g,&I & 3 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. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: IState: 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 Count an posted on the jobsite before the first inspection. If you intend to obtain financing, consult with n r n attorney before commencing work or recording our Notice of Commencement. Signatur Owner/Lessee/Contractor as Agent for Owner ure of Contractor/License Holder STATE FLORIDA STATE OF FLORIDA �n COUN OF COUNTY OF ��� FEU e✓ Sw9rn to(or affirmed)and subscribed before me of Swo1n to(or affirmed)and subscribed before me of V Physical Presence or Online Notarization V Physical Presence or Online Notarization this day of h1dl yK`�n��/ L 2020 by this_,-;2_day of n _��n�e 2020 by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced (SignstN + bliCHRIS�EOl NNIorida ) (Sig ure of Notary Pu ' -St '��#' rid t.MGM ;,CommleebnNGO326924 ,r C�o�nmlaelon GG32888f Commi E xD(re/JUn029,20�lleal) Commission No. u+� oP�' g June 6,2023 ►(�,•' sond�CThruTroyUnMuma1004WO11 rF� s. 81491M-WY3mkw REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. PERMIT# / ISSUE DATE ' / ' � l PLANNING & DEVELOPMENT SERVICES �' y _:=ftAJLL Building & Code Compliance Division R BUILDING PERMIT SUB-CONTRACTOR AGREEMENT COMPLETE ELECTRIC, INC. have agreed to be (Company Name/Individual Name) the ELECTRICAL Sub-contractor for CHRISTOPHER PINSON-INDIAN RIVER DOCKS LLC (Type of Trade) (Primary Contractor) For the project located at 122 QUEEN FREDERIKA COURT, FORT PIERCE, FL 34949 (Project Street Address or Property Tax ID#) It is understood that, if there is any change of status regarding our participation with the above mentioned project,the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the filing of a Change of Sub-contractor notice. '7 tAi ATURE Qualifier) / SUB-CONTRACTOR SIGNATURE 'ter) Q.v GARETT GUIDROZ PRINT NAME I EC0001911 COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER State of Florida,County of _.11 40_� State of Florida,County of INDIAN RIVER The foregoing instrument was signed before me this 22ND g B g �day of The foregoing instrument was signed before me this day of 202L,by (9,0$cr> JANUARY 20_,by GARETT GUIDROZ who is personally known�or has produced a who is personally known Xor has produced a as identification. as identification. 1 _ STAMP STAMP Sign ire of Notary P lie Signature of Not»ry Puhlic MACI COOK � .�a ,_ Print Name of Notary Pu Print Name of Notary Public—� :i+''""' ':--- MACI COOK a— .; .: MY COMMISSION#GG 926898 y'vk JANICE L.LEGER =�; '° EXPIRES:October 28,2023 `F`F FyOQ' Bonded Thru Notan/Public Underwriters* Commission*GG 328NI _ __ Expites June 6,2023 - 'PQfF�o� P�'1edTNuBuAy�tDbyry3w� Revised (1/1612016