HomeMy WebLinkAboutBuilding Permit ApplicationJ
All APPLICABLE INFO MUST BE COI fFU i ED FOR APPLICATION TO BE ACCEPTED !�
Permit Number: 9`1 ty— 0 5-I
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Date:
9Uo
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address:
Commercial
CBDG Funding
Residential
--
Property Tax ID #: Le i a— b �,(�( -Di:V -4-4 Lot No. 19
Site Plan Name: Block No. i -3�3_
Project Name:
--
SFn
New Electrical Meter Second Electrical Meter (Affidavit required)
COIVSTRUCTiON`tNFORMAT[ON
Additional work to be performed under this permit —check all that apply:
XMechanical _ Gas Tank Gas Piping (Shutters —)( Windows/Doors _ Pond
-XElectric )( Plumbing _XSprinklers _ Generator -X Roof
Pitch
Total Sq. Ft of Construction: _Q3 d Sq. Ft. of First Floor: I S--?
Cost of Construction: $ )ILa)y-&_ Utilities: _Sewer (Septic Building Height:
OWIVER�LESSEE.
_.. .__. ,_. _ ., ..... _ .-., ... .. .. .. .....,. ,- _,
CQ(VTRACTOR
.. �. -..... _...e _. .c �... ..._ ..
Name Focus Homes. LLC of Florida
Name: Mark Richard
Address: 1686 W. Hihiscl.lsRlvd
company:Focus Homes, LLC of Florida
city: Melbourne State: FL
Zip Code: 32901 Fax:
Phone No.'121-725-5Fi45X3763 E-
Address: 1686 W. Hibiscus Blvd
city: Melbourne State: FL
Zip Code: 39901 Fax:
Phone No 321-725-5645
Mail: Weit7r C�T mamnda cnm
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-MailVVPjt7rgMarpnda com
State or County License CBC 1255394
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'CONSTRUCTIOIV LIEN LAW INFO MATION
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable
Name: FDS Engineering and Associates Name:
Address: 258 Southhall Lane Suite 200 Address:
city: Maitland State: F1 City: State:
Zip: 82751 Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:
Address:
City:
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 lender or an attornev before commencing work or recording vour Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF Brevard
Swor o (or affirmed) and subscribed before me of _ Physical Presence or Online Notarization
this day of / , 2021 by
Name of person making statement.
Personally Known XX OR Produced Identification
Type of Identification Produced
(Si ure of Notary Publ' tate of Florida)
REBECCA WEITZ
Commission No. Seal MYCOMMISSION # HH 080345
( ) *: f} : ;
EXPIRES: March 16, 2025
3onded Thru Notary Public Underwriters
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