HomeMy WebLinkAboutBuildling Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
r Building Permit Application
Planning and Development Services
Building and Cade Regulation Division Commercial Residential x
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
MENT LOCATION:
Address: 2408 HARBOUR COVE: DR rl ; L
Property Tax ID #: 1425 701 0064 050 1 Lot No.
Site Plan Name: AUSRA'S RESIDENCE Block No.
Project Name:
DETAILED DESCRIPTION OF WORD:
CHANGE OUT FRONT DOOR - -' " NO SIZE (_.RANGE
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -- check all that apply:
—Mechanical _ Gas Tank _ Gas Piping Shutters v*"'Wind0W5/J1( as _ Pond
Electric _ Plumbing —Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ '7 3 75 Utilities: _ Sewer __ Septic Building Height:
OWN ER/LESSEE: CONTRACTOR:
Name AUSRA JAKUBOVIENE
Name: JAMES D.DAVIS
Company: J&G CARPENTRY INC
Address: 2408 HARBOUR COVE DR
City: HUTCHINSON ISLAND State:
Address: 13461 79TH CT N
City: WEST PALM BEACH State: FL
Zip Code: 34949 Fax:
Phone No. 410 340 7351
E-Mail:
rip Code: 33412 Fax:
Phone No 561-855-4052
E-Mail
Fill in fee simple Title Holder on next page if different
State or County License CGC 022831
from the Owner listed above)
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 LAVA INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
Address:
City: State:
zip: Phone
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:_
Address:
City.
Zip:
Phone:
MORTGAGE COMPANY: x Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: x Not Applicable
Name:_
Address:
City.`
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 is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home 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.
Lurie Countv and posted on the iobsite 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 wnerl Less e eA5dfi tractor as Agent for Owner
Signature of C c or/License Holder
STATE OF FLORID
STATE OF FLORIDA
b
COUNTY OF—J
COUNTY OF IP&l
Secyn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Prese or Online Notarization
Physical Presence or Online Notarization
thas day of 202Zby
this � day of �� runic .f Eby
(A s D. Qa j _
Name of person making statemeift.
Name of person making statement.
Personally Known OR Produced Identification
Personally known OR Produced Identification
Type of Identificati
Type of Identification
Pr duce d
Produced
(Signature o
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