HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MusT BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q
Date: 02/15/19 Permit Number:
RECEIVED
- ---- — Building Permit Application FEB a s tots
Planning and Development Services
Building and Code Regulation�Division permitting Department
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lude County
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT TYPE:,Roof
Address:
Property Tax ID #:
Site Plan Name:
Project Name: _
Of
Additional work to be
Mechanical
_ Electric
Total Sq. Ft of Constructii
Cost of Construction: $ 1
FL
-0003-010-1
5v Metal w/ exoosed
Lot No.
Block No.
med under this permit— check all that apply:
Gas Tank _Gas Piping _Shutters —Windows/Doors
Plumbing _Sprinklers _Generator _Roof 5/12 Pitch
1800 - Sq. R. of First Floor: 1444
Utilities: _Sewer _Septic Building Height! 17
r,�,WN�F�LESS,EE� �
r,CONTRACTO[
Name Roy G & Christine F Parker
Name: Cameron Conner
Address:18491 Oranaelave
Company: CamcD Sales. Inc
City: Fort Pierce _ State: _
Zip Code: 34945 C Fax:
Phone No.
Address:12575 164 th Ct North
city: JuDiter state: FL
Zip Code: 33478 Fax: 772-264-0254
Phone No 772-742-1200
E-Mail: I
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail Camcol9@bellsouth.net -
state or county License CCC042804
irvaiue or construction is 4i 5UU or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
I
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11
UC31uINICKI MUIRt[n: v Not Applicable
Name:'.
Address:'
City I -- - - -- - -State: - - -
Zip: _ Phone.
FEE SIMPLE TITLE HOLDER: v Not Applicable
Name:'__
Address:' -
City.
zip: ° Phone:
MORTGAGE COMPANY: _ Not Applicable
Name: .
Address:
City: - -- - - - - —State:
Zip: Phone:
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 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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
SlgefatGre of Owner/ s ntractor as Agent for Owner
Signature of Contractor�ense Holder
STATE OF FLOZ
COUNTY OF"
STATE OF FLORIDA A&
COUNTY J%ti
OF- 9
The forgoing instrument as acknowledge efore me
day 7
this �o
The forgoing instru t as acknowledged before me
f , 2.04141 by
thislLdayof 6c�'<1.' 26ZY.by
Name of person making statement.
Name of person making statement.
Personally Known ' . OR Produced Identification
Personally Known � OR Produced Identification '
Tlype of Identificoon _
Produced -%2cc has L rc6ng�,
Type of Iden7;* iicition
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(Signature of tary Public- Stat o orida) 0.9AUREENA OOOPER (Signature of Notary P a
COOPER
Commission No. " MVcommuIOHi mew MAUREEll0.
- eal IRES:JAN 0�, 2023 ommission No. �MY CGMMI59 # G299442
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