HomeMy WebLinkAboutBUILDNG PERMIT APPLICATION-Needs updatesAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
S L LIl�LL
L Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential Yes
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding Yes
PERMIT APPLICATION FOR: New build at 4804 El Nueva Avenue
PROPOSED IMPROVEMENT LOCATION:
Address: 46U4 ti Nueva Ave, Fort Tierce, Florida, 34946
Property Tax ID #: 1431-703-0028-000-7
Site Plan Name:
Project Name: New build 4804 El Nueva Avenue
DETAILED DESCRIPTION OF WORK:
New single-family residence for CDBG-DR Rebuild program
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Lot No. 7 & 8
Block No. B
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: 1926
Cost of Construction: $ 150.000.00
Sq. Ft. of First Floor: 1926
Utilities: XSewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Samuel Smith
Name: Paul Judson
Address: 48n4 FI Nueva Avenue
Company: Stonewater Inc
City: Fort Pierce State: Fl
Zip Code: 34946 Fax:
Phone No. 772-489-0776 E-
Address: 2005 Post Office
City: Galveston State: TX
Zip Code: 77550 Fax:
Phone No 843-906-0898
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail kenneriy gPrrarr rlcwhnmPc rnm
State or County License CRC1332722
u vame or construction is ouu or more, a ntcuitutD notice of commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. 11
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
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 conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult 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 attorneybefore commencingwork or recordin our Notice of Commencement
Sign ure of Owner/ Lessee/Contractor as Agent for Owner
ATE OF FLORIDA
COUNTY OF Ora t-, G7 iP
Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization
this nday of IV0V 20a1by
PaLC4 JGtd dGh
Name of person making statement.
Personally Known ✓ OR Produced Identification
Type o dentification Produced
(Signature of Notary c- State of Florida)
/Ptul
t-9 g Public State of Flontla
Commission No. 6 1/ / Z
S�I) a
Ashley DunneMyCommission
GG 949276
Expires 0l/212024
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