HomeMy WebLinkAboutPermit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
L-UIll
- a -f Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial X 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: 4527 S US Highway 1
Property Tax ID #: 3403-502-0008-000-3 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Concrete Block Infill For 2 Existing Doors & 1 Window,
This Work Has Been Previously Completed Without A Permit. See Attached Paperwork For Referance.
New Electrical Meter Second Electrical Meter_
(Affidavit required)
CONSTRUCTION INFORMATION: I
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: _
Cost of Construction: $ 2,250
OWNER/LESSEE:
Sq. Ft. of First Floor:
Utilities: —Sewer Septic
Name 4527 Fort Pierce LLC
Address:1640 S State Road 7
City: Hollywood State: FL
Zip Code: 33023 Fax:
Phone No. E-
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
Name: Devin Wheaton
Building Height:
Company. Treasure Coast General Contractors, LLC
Address: 1720 Copenhaver Road
City: Ft. Pierce State: FL
Zip Code: 34945 Fax:
Phone No
E-Mailtreasurecoast c mail.com
State or County License CGC1 526542
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: _
Address:
City:
i Zip:
Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
Citv:
Zip: Phone:
Not Applicable
State:
Not Applicable
MORTGAGE COMPANY:
_ Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip:
Phone:
_ l
Not Applicable
State:
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 Ham eownersAssociation 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 len or n attorne efore commencing work or recording your Notice of Commencement.
Signature of Contractor - or - Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF S-—c-c-c
Sworn to (or affirrped) and subscribed before me of Physical Presence or Online Notarization
this 2taday of Lyl, wr Ps 20-2aby
/� ; v+ nJ � e O ✓1
Name of person making statement. `
Personally Known _ ..—OR Pr id Identification 1%
Type of identification Produced Lf
(Signature of Notary Public- State of Florida)
Commission No.GG 20, ZZ 7.ISeal)
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
_RECEIVED
DATE
COMPLETED
ev 1071272-1
0 Notary Public State of Florida
Colleen Sue Hayes
My Commissisn GG 297729
N w Expires 03/15/2023
SUPERVISOR PLANS VEGETATION
REVIEW REVIEW i REVIEW
SEA TURTLE MANGROVE
REVIEW REVIEW
I