HomeMy WebLinkAboutBuildling permit app main houseAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
O 4�1
° 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: Main House I
I IMPROVEMENT LOCATION: "
Address: b it
Property Tax ID a:
Site Plan Name: _
Project Name: _
Lot No.
Block No.
Remove current shingle root to oeCKing, replace any rotten wuut
and re nail to code, install self adhered underlayment, install 5V
metal roof to code
New Electrical Meter Second Electrical Meter (Affidavit required)
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 4/12 Pitch
Total Sq. Ft of Construction: 50 Sq. Ft. of First Floor: 1350
Cost of Construction: $ _$5500 Utilities: _Sewer _Septic Building Height: 141
tER;/LMEE:
CONTRACTOR:
Name Gail mundanioniName:
Harold o
Address: 6108 Cassia Dr
Company: Otto Built LL
City: Fort Pierce, State: FL
Zip Code:34C)82 Fax:
Phone No. E-
Address:4335 Sw Honey Ter
City: Palm City State: FIL
Zip Code: 34990 Fax:
Phone No 77�1079
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail Harold ott0 UI .cord
State or County License
IT value or vannrucuon is dwu 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:
utbIbNtn/tNt,rNttH: _ 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 I BONDING COMPANY: _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 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
improv ments to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie (;�unty and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with l er or an attorney before commencing work or recording vnur NnrirP of rnmmPnrPmPnr
Signatw of Con —tractor - or - Owner Builder as applicable
STATE OF FLORIDA I /
COUNTY OF
Swoo[��fo (or affirmed) and subscribed before me of
r
_ Physical Presence or _ Online Notarization
this IU day of IiLCZ V CYO .20 ZIL-by
L- (AroI (A oG
Name of person making statement.
)<
Personally Known OR Produced Identification
Tntification Produced
C1, (mot.(//
(Signature of Notary Publid/ State i a Flor
�'��Pu�
Commission No. �I-S�
r� tisgr NANCY HAGiERHORSTNotary
al)
Public
,z State of Florida
Comm# HH167992
191 Expires 8/23/2025
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