HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2/24/2022 I Permit Number: 40(oz. 0011
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
Commercial
CBDG Funding
Residential X
PERMIT APPLICATION FOR Single Family Residential Home -Two Story
PROPOSED IMPROVEMENT LOCATION.:
rown Uourt, Fortierce,
Address:
1414-701-0180-000-1 P
Property Tax ID #: Lot No.
Site Plan Name: Queens Cove, Unit 1 Block No.18
Project Name:
Patterson Residence
DETAILED DESCRIPTION OF WORK:
uIldiConstruct a I wo-Story Single Family Residential Hom6, otal Area
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
X Mechanical X Gas Tank X Gas Piping _ Shutters X Windows/Doors _ Pond
X Electric X Plumbing _ Sprinklers _ Generator X Roof 12/4 Pitch
Total Sq. Ft of Construction: 4131 Sq. Ft. of First Floor: 2019
Cost of Construction: $ 810,000 Utilities: _ Sewer X Septic Building Height: 291411
.:OWNER/LESSEE:
CONTRACTOR:
"I
Name Douglas Fraser Patterson
Name: Richard A. Adarns
Address: 523 Charles Hill Road
City: Santa Cruz State:CA
Construction Corp o the reasure o
Company.
Address:850 NW Federal Hwy., Ste. 226
City: StuartState:
Zip Code: 34994 Fax: 46-45'f2F—
Phone AQ 772-446-4576
Zip Code: 95065 Fax:
Phone No. 634-34b-98 E-
Mail:DTP
Fill in fee simple Title Holder on next page (if different
E-Mail
State or County License
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 LAW -INFORMATION;
DESIGNER/ENGINEER: Not Applicable
Name: MK Structural Engineering
AddrMes�
City: e Mate:
rL
Zip: 32935 Phon
FEE SIMPLE TITLE HOLDER:
Name:
Address:
Citv:
Zip: Phone: _
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
Citv:
!Zip: Phone:
Not Applicable
DWNFR/ CONTRACTOR AFFIDVIT' Annliration is herehv made to nhtain a nermit 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.
Lucieounty and posted ornthe jobsite before the first inspection. If you intend to obtain financing, consult
with fonder or an attorne,/before commencing work !or recording your Notice of Commencement.
c
Signature of Contractor - or -Owner Builder as applicable
�► Y pu"•.. CHERYL A, FINK
?°: Notary Publlc • State of Florlda
�4AF Commission N GG 216951
STATE OF FLORIDA
'°F.`` My Comm. Expires May 13, 2022
COUNTY OF SA-1 0 T L—U C j C
Sworn to (or affirmed) and subscribed before me of Physical Presence
or Online Notarization
this day of Q r�eA2y 20oVby 1CiF/f12D
9.1 Cfh`tfLD 4 - t DA-%2_-6 =
Name of person making/statement.
Personally Known v OR Produced Identification
Type of I ti ' ation Produced
�. 2 yr_�
(Signature of Notary ublic- State of Florida)
Commission No. Al (Seal)
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Rev 10/12/21