HomeMy WebLinkAboutBUILING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 4624578
Address: 449 Gokchoff RD Fort Pierce, FL 34945
Property Tax ID #: 2310-801-0064-OOU-3
Residential
Lot No. 2-12
Site Plan Name: Block No. F
Project Name: David Lealond Atkins
New Electrical Meter Second Electrical Meter
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: Sq. Ft. of First Floor:
Cost of Construction: $ Vo \E'>n , Utilities: _ Sewer _ Septic Building Height:
ownrtRjl_Ess��
Name David Lealond Atkins
Name: Scott Berman
Company: Florida Window & Door
Address:449 Gokchoff RD
City: Fort Pierce
State:
Address: 1125 N Dixie Highway
_
Zip Code: 34945 Fax:
City: Lake Worth State: FL
(919) 306-2146
Zip Code: 33460 Fax:
Phone No.
Phone No 561-340-4300
E-Mail:lay,i 011 alKo t1a ca CCmn
Fill in fee simple Title Holder on next page (
if different
E-Mail howard@floridawindowanddoor.com
—
from the Owner listed above)
State or County License 28576
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:
Name:
_ Not
Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone
FEE SIMPLE TITLE
Name:
HOLDER: Not
Applicable
BONDING COMPANY: Not Applicable
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 Countyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in con, with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Flome Owners 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 your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA LUC, 4C
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
'Physical Prese ce or Online Notarization
this ,,Zq day of 202d by g�lWid
Lealond Atkins
Name of person making statement. � Z ��
Personally Known roduced I"ftali m
Type of Identification z` `�'��` notary Puonr state o` Florida
Commission. = GG 340327
Produced 1CCI L' a:
/ F` y m. z�!res ju! 28, 2023
0,
ii dh 3oncee through tiaUora, rotary Assr,
(Signature of Notary Public- State of Florida)
31!� 1�tia �e�t co, test
Commission No.
got �►�?A
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Signature of Contractor/License Holder
STATE OF FLORIDA
CO U NTY O F Pam eeah
Sw rn to for affirmed) and subscribed before me of
Ph 'cal Presenc�,or Online Notarization
this7 ay of 202aby
Scott Berman
Name of person making statement.
Personally Known X
Type of Identification
Pro
duced
(Signature of Notary Pu
Commission No.
PLANS VEGETATION
REVIEW REVIEW
OR Produced
identititation
State of
4?
�pRY PU¢�S��gg) ry Public State of f
`Je�ifer S Fettes
„� ;-; � My Commission GG 21
.A TURTLE MANGROVE
REVIEW REVIEW