HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
(� Ib OO R1 U U ti
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION.
Address: 7301 San Carlos Dr Fort Pierce, FL 34951
Property Tax ID #: 13Q1-601-0115-000-1
Site Plan Name:
Project Name: Jean Hazellief
DETAILED DESCRIPTION OF WORK:
New Electrical Meter
Second Electrical Meter
CONSTRUCTION INFORMATfON:
Additional work to be performed under this permit —check all that apply:
Residential X
Lot No. 16
Block No. 7
_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: $ _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Jean Hazellief
Name% Scott Berman
Address: 7301 San Carlos Dr
Company: Florida Window & Door
City: Fort Pierce State: _
Zip Code: 34951 Fax:
Phone No. 772465-3038
E-Mail:
Address: 1125 N Dixie Highway
City: Lake Worth State: FL
Zip Code: 33460 Fax:
Phone No 561-3404300
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail howard@floridawindowanddoor.com
State or County License 28576
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
Name.
Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
Address:
City: State:
Zip: Phone.
FEE SIMPLE TITLE HOLDER. _ Not
Name.
Applicable
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Address:
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.
Inconsideration 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 your Notice of Commencement.
STATE OF FLORIDA.
COUNTY OF '� • V.,'Cl f
Swor�rto (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this L5 day of 202(1s by
Jean Hezellief
Name of person making statement.
Personally Known _
Type of Identification
Prodmed
`L OR Produced Identification
Sign
STATE OF FLORIDA
COUNTY OF_Pa�maea�,
nse Holder
Sworn to for affirmed) and subscribed before me of
Physical Presence or Online Notarization
this 2 nay of �j�S»( , 2020 by
Scot Berman
Name of person making statement.
Personally Known x OR Produced Identification
Type of identification
Produced
(Signature of Notary Public- State of FI a) Lauren Arend Sign ture of of ry Publils�St'�e f,j;+lo '"°"''" �"""`' J"" "'
� ",�'ti`�t� o�, NOTARY PUBLIC _ ,, � My Comm ss ontGG 2
Commission No. � 3sa�LSt�9M e STATE OF FLUK11imommission No. —b o�M1�ea&j�PresoStisno22
Comm# GG35295
0
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
COMPLETED
5