HomeMy WebLinkAboutPERMIT APPLICATIONAll APPLICABLE INFO MIST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number.
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce A 34982
Phone: (772) 452-1553 Fax: (772) 462-1575
Commercial Residenflal X
CBDG Funding_
PERMIT APPLICATION FOR: GALT
PROPOSED IMPROVEMENT LOCATION:
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Address: 9701 S INDIAN RIVER DR., FT PIERCE 34982
Property Tax ID #: 3529-221-0002-000-6 Lot No.,
Site Plan Name: Block No.
Project Name: GALT DOCK
DETAILED DESCRIPTION OF WORK:
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41.0 w4 tv
Nekv Electrical Meter kl/A Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be
performed under
this permit -- check
all that apply:
_Miechanica[
� Gas Tank
_has Piping
� Shutters
X Electric
Plumbing
Sprinklers
(Affidavit required
Generator
Windows/Doors Pond
Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction : z-,2J 0 oe co
'.....� Utilities: Sewer � Septic Building Height:
OWNER/LESSEE:
Name TODD & DANA GALT
Address: 8895 YEARLING DR
01tyl,
I_1NO&IFiKi];i9:
1'p Code*
Fa x a -
State: FL
Phone No. E-
ail:
Fill in
fee
simple
Title Holder on next page cif different
from
the
owner
listed above)
CONTRACTOR:
Name: CHRIS RIENDEAU
Company: XTREME ELECTRICAL SERVICES
Address: 11101 S INDIAN RIVER DR.
City: FORT PIERCE State: FL
Zip Code: 34982 Fax: 772'353-5078
Phone No 561-333-9519
E-Mail ARIENDEAU@YMAIL.COM
State or County License EC13005450
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: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: Not Applicable
Name: ni I �}.
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.
t. Lucie oumy retakes no representation that is
�ainting a permit will a uth riz the permit holder to build thesubject structure
which conflicts r1th are appl1 able Ho eown r o iation rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consuft with your Homeowners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, t do hereby agree that f will., in all respects, per -form 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,
access d ry 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 comrnencin work or recordine vour Notice of Commencement'.
i naW of Contractor - or - Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF M C1 V-ti Yl
Sworn to or afFirm�d}and subscribed before me of
this �tay of �Q Y1L{ QL ni 2023-. by
/ l
j�( — Physical Presence or Online Notarization
Name of person rriak'Ing statement.
y
Personally Known OR Produced Identification ---
Type of Identification Produced
(Signature of Notary Public- State of Florida)
Commission Na. i (Seal)
REVIEWS
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RECEIVED
DATE
COMPLETED
e
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
RE TI NA MATHISON
Notary Pubis. State of Florida
Commission# GG 913030
MY COMM. expires Sep. 2B. 2023
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