HomeMy WebLinkAboutBUILDING PERMIT APPLICATION J
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 01/24/21 Permit Number: aa�1-�rJd15
RECEIVED
o r s JAN 2 6 2021
..... BuildingApplication p Permit An licati St.Lucie County
Permitting
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: 10x10 shed
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Address: 2004 N 33rd ST Fort Pierce FL
Property Tax ID#: 2405-501-0033-000-7 Lot No.
Site Plan Name: Block No.
Project Name: Shed
Install 10x8shed
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: 100 Sq. Ft.of First Floor:
Cost of Construction:$ 1500.00 Utilities: —Sewer —septic Building Height:
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Name Gonzalez Laparra Rudi O Name: Roderick Waller
Address: 1590 Alison DR Company: Sunrise City CHDO, Inc
City: West Palm Beach State:FL Address: 130 S. Indian River DR
Zip Code: 33409 Fax: City: Fort Pierce State: FL
Phone No. E- Zip Code: 34950 Fax:
Mail: Phone No 772-201-2850
Fill in fee simple Title Holder on next page(if different E-Mail rodwaller1@gmail.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.
5UP�IEiVIE�I" L CONSTRUCTIO LIEN LAW INFQRMATIQN
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: ✓ of Applicable
Name: 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.
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.
Signature f'Own er/Less a ontractor as Agent r Owner
STATE OF FLORIDA
COUNTY OF scAude
Sworn to(or affirmed)and subscribed before me of xx Physical Presence or Online Notarization
this 24 day of January , 20_by
Name of person making statement.
Personally Known OR Produced Identification xx
Type of entification Produced FuoL
(Signature of Notary Public-State of Florida)
Commission NoLt (Seal) �p400N Notary Public State of Florida
Eric Harrell
My Commission GG 913269
�7a a Expires 09/15/2023
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