HomeMy WebLinkAboutBUILDING PERMIT APP1ti
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
9t L�c�uL�
0
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:
IPROPOSED IMPROVEMENT LOCATION:
,
Address: 7505 S Indian River Or - Fort Pierce
Property Tax ID R: 3518-212-0002-050-9 Lot No.
Site Plan Name: Block No.
Project Name: Wade
I DETAILED DESCRIPTION OF WORK: IIIIIIIIIIIF I
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION: - ---� -
Additional work to be performed under this permit —check all that apply
_Mechanical
_Gas Tank
_Gas Piping
XShutters _Windows/Doors _Pond
_Electric
_Plumbing
_Sprinklers
_Generator _Roof Pitch
Total Sq. Ft of Construction:
Sq.
Ft. of First Floor:
Cost of Construction:
$ 4727
Utilities:
_ Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Dana & Deena Wade
Name: Edward J Heritage
Address: 7505 S Indian River Dr
Company: Folding Shutter Comoration
City: Fort Pierce State: _EL
Zip Code: 34985 Fax: n/a
Phone No. 772-971-6605 E-
Address: 1862 Dr Martin Luther Kona Blvd
city: West Palm Beach State: FI
Zip Code: 33404 Fax 561-640-8204
Phone No 561-683-4811
Mail: n/a
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-mail info0foldinashutters.com e "
State or County License SCC131151041
It value of construction 15 Z50a or more, a RLLURULU notice or commencement Is regwrea.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
113117A
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
_Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone
State: _
City:
Zip: Phone:
State: _
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
Address:
City:
Cm
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 recresentation that is Vnting a permit will authorize the permit holder to build the subject structure
which conflicts with an applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consuYt 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 attorney before commencine work or recording vour Notice of Commencement.
Signature of on essee ctoras Agentfor Owner
STATE OF FLORIDA
COUNTY OF PALM BEACH
SwornSo (or affirmed) and subscribed befo(e me of XX Physical Presence or Online Notarization
this f day of (l&C 2021 by
Edward J Heritage
Name of person making statement.
Personal) Known (�. OR Produced Identification
Typ of l ntificetion Produced
(Signature of Notary Public- State of Florida) PmnmaiA Evans
TARY PUBLIC
Commission No. (Seal)ATE OF FLORIDA
Upirm10/1112022
mra OG282789
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev SRuy21