HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
�J
Building Permit Application
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:
PROPOSED IMPROVEMENT'LOCATION:
Address: 6815 Thoreau Ter. Port St Lucie, FL 34952
Property Tax ID #: 3415-705-0021-000-0 Lot No. 20
Site Plan Name: Block No. 1
Project Name:
DETAILED DESCRIPTION OF WORK:
replace 7 windows size for size vvt p #%CrV
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters
(Affidavit required)
Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator _ Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 10779.00 Utilities: —Sewer —Septic
Building Height:
Pond
Pitch
OIINER/LESSEE:°
CONTRACTOR:
Name Stephanie Kisloski
Name: Roberto Sanchez
Address: 6815 Thoreau Ter.
Company: The Home Depot
City: Port St Lucie State: FL
Zip Code: 34952 Fax:
Phone No. E-
Address: 2455 Paces Ferry Ln. C-11
City: Atlanta State: GA
Zip Code: 33039 Fax:
Phone No 754-224-2010
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail robertosanchezthd@expeditepermit.com
State or County License CGC1522717
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_
FEE SIMPLE TITLE HOLDER:
Name:
Address:
Citv:
Zip: Phone: _
Not Applicable
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone: _
Not Applicable
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 lanriar nr an attnrnav hafnra rnmmpnrinR wnrk nr rPcnrding vnur Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF L kx"k—
Sworn o (or affirmed) and subscribed befo e me of
day OV 20-0 by
Physical Presence or Online Notarization
this of
W bznln �Sntkt
-
Name of person making statement.
Personally Known OR Produced Identification
Type o ti o uced
(S. a of No Public- S of FIori
JONATHONTHOMAS
'
MY COMMISSION # HH 144714
�-
Commission No. (Seal),a;
EXPIRES: September 18,2025
''�
Banded T Nu Notary WWI Undetvrtfurs
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 5/zu/L1
/► It7teS9 — li J-SIoSk �