HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE
Date: 10/1612019
-EYED FOR APPLICATION TO BE ACCEPTED ((�� //��
�4 Permit Number: 0 10)
• RECEMD
Bui rmit Application
Planning and Development Services�I�iV pp OCT Y 6 Z819
Building and Code Regulation Division BY Permitting Department
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie County St. Lucie County
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMITTYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 5175 Southwind Trail
Property Tax ID #: 1418-211-0010-000-7
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Putting a garage on the property, No plumbing, No electrical, Free standing building
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I.CONSTRUCTION INFORMATIONk
Additional work to be performed under this permit —check all that apply:
Lot No.
Block No.
_Mechanical _ Gas Tank —Gas Piping _ Shutters —Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: 768
Cost of Construction: $ 10,000
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height: 13ftiin
OWNER/LESSEE:
CONTRACTOR: "
Name Kenneth Eden
Name: Kenneth Eden
Address:5175 Southwind Trail
Company:
City: fort pierce State: _
Zip Code: 34951 Fax:
Phone No.7726339101
Address:5175 Southwind Trail
City: Fort Pierce State: Fl
Zip Code: 34951 Fax:
Phone No7726339101
E-Mail:tctagsl3@yahoo.com
Fill in fee simple Title Holder on next page ( if different
from the owner listed above)
E-Mailtctagsl3@yahoo.com
State or County License
If value of construction is $2500 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.
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: '�C Not Applicable I BONDING COMPANY:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
Applicable
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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITEI YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signatu f Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Sir. 1 ace ?
COUNTY OF
The forgoing instrument was acknowledged before me
la
The forgoing instrument was acknowledged before me
this day of Gc1 .20"1 by
this_dayof .20_ by
51414'Nr -A ITN 'E�Q_r
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced L D L
Produced
(Signature of NotAy bH'.7,E of FI& E'OiVi:R
IBSIONg00022023
(Signature of Notary Public -State of Florida)
g mbef 16, 2M
:jypeblloundenyritea
Commission No. .60
Commission No. (Seal)
Bonded
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