HomeMy WebLinkAboutBUILDING PERMIT APPLICATION 4
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ^ - ® �
Date: 1/21/22 Permit Number:
RECEIVED
JA N 2 1 2021Building Permit Application
St.Lucie County ,
Planning and Development Services Permitting
Building and Code Regulation Division Commercial Residential XX
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 CBDG Funding
PERMIT APPLICATION FOR:Stucco
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Address: 2515 Kerr St Fort Pierce FL 34946
Property Tax ID#: 2419-601-0019-000-3 Lot No. .
Site Plan Name: Block No.
Project Name: AGOW
Stucco entire building
New Electrical Meter Second Electrical Meter (Affidavit required)
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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: 1251 Sq. Ft.of First Floor: 1251
Cost of Construction:$ 2235.00 Utilities: _Sewer _Septic Building Height: 8'
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Name Dorothy Barron Name: Roderick Waller
Address: 5102 Avienda Ave Company: Sunrise City Concrete Services Inc
City: Fort Pierce State:_ Address: 130 S. Indian River Dr.#202
Zip Code: 33478 Fax: City: Fort Pierce State:
Phone No.772-267-5550 E- Zip Code: 34950 Fax: 772-907-0420
Mail: Phone No 772-201-2850
Fill in fee simple Title Holder on next page (if different E-Mail rodwallerl@gmaii.com
from the Owner listed above) State or County License CGC1515114
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.
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�SUPPI�MENT�1� QNSTRICTI
DESIGNER ENGINEER: ✓ Not Applicable MORTGAGE COMPANY: ✓ Not Applicable
Name: Name:
Address: Address:
City: State: City: State: I
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: ✓ Not Applicable BONDING COMPANY: ✓ Not Apr lic ble
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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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 attorney before commencing work or recording our Notice of Commencement.
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Signature of Contractor-or-Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF St Lucie
Sworn to(or affirmed)and subscribed before me of XX Physical Presence or Online Notarization
this 21th day of January 20 22 by
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Name of person making statement.
Personally Known XX OR Produced Identification
Type o enti ation Produced
(Signature f Notary Public-State of Florida)
Commission No. (Seal) 40 Notary Public State of Florida
a4 Sophia Harris
My commission HH 0052J53
Expires 0513V202I
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