HomeMy WebLinkAboutSavannas Preserve Permit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
CiiU L ti (mo_
�7
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: Carport Replacement
PROPOSED IMPROVEMENT LOCATION:
Address: 9501 Gumbo Limbo Lane Building #4
Property Tax ID #: 4505-110-0005-000-5 Lot No.
Site Plan Name:
Project Name: Savannas Preserve State Park
DETAILED DESCRIPTION OF WORK:
Replace existing carport on residence (Classified as building #4)
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
Block No.
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: $ / I, / Utilities: —Sewer _ Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Tr Int Imo Trust Fund
Name: John ZeryOpoulos
Company: Advanced Hurricane Protection
Address: _3900 Commonw al h Blvd
City: _ Tallahassee, State: FL
Zip Code: 32399 Fax:
Phone No. 772-919-1491 E-
mail: In_eph Robert_-;(�dPn _"tat fl iS
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Address: _4517 RF Commerce _Ave
City: Stuart State: El___
zip Code: 34997 Fax:
Phone No 772-220-1200
E-mail John(cDAdvancedHurricane. net
State or County License_ CRC 1959339
II .. "' �. ""' Mb4 " ore, a RECOnwre, a rceCommencement is required.
wrcuw rvotice or commencement is required. I
If value of HAVC is $7,500 or more, Notice of C
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: _ Name: _
Address: Address: _
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
Not Applicable
BONDING COMPANY: Not Applicable
Name: _
Address:
City:
Zip:
. To -
UWNLR/ LUNTRACTOR 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 cogwigmving work nr rPrnrclinrs vnr rr Nntiro of rnmmonromont
Si=ureof tr r - or -Owner rl er as applicable
SRIDA
COUNTY OF Martin
Sworn (or affirmed) and subscribed before me of
X Physical Presence or Online Notarization
this day of , V , ZZby
Name of person making statement.
Personally Known X OR Produced Identification
Type of Identification Produced
_
(Signature of N tary Public- State of Florida)
Commission No. HH 1465�8 (Seal)
MELISSA A. EWOLDT
"
MY COMMISSION#HH146508
;ro : EXPIRES: August 10, 2025
F°F..... Bonded Thru Notary Public Underwriters
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