HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 0 ' j / Permit Number: 170,).
_ E
Building Permit Application FEB ®1 2017
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce rL 34982
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
"PROPOSED IMPROVEMENT LOCATION.
Address: 4032 Greenwood Drive Fort Pierce, FL 34982
Legal Description: GREENWOOD BLK 1 LOT 17(0.51 AC)(OR 559-330)
Property Tax ID#: 2421-702-0018-000-3 Lot No.17
Site Plan Name: Block No. 1
Project Name:
Setbacks,- Front Back: Right Side: Left Side:
D'ETAILED,DESCRIPTION-_OF`WORK:
CONSTRUCTION INFORMATION:
Additional work to be nerformed under tispermit—check all appy:
❑HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers 0 Generator L3 Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ �fC3(J �'� Utilities:Sewer Septic Building Height:
QWNER/LESSEE: CONTRACTOR:
Name Steven H Marshall Helen D Marshall Name' Robert Lynch
Address:6907 S Indian River Drive Company: Third Day Electric,LLC
City: Fort Pierce State:FL Address: 2057 SE Mary Ter
Zip Code: 34982 Fax: City: Port Saint Lucie State:FL
Phone No.772-46473376 Zip Code: 34952 Fax:
E-Mail:helenmarshallfau@yahoo.com Phone No. 561-935-8540
Fill in fee simple Title Holder on next page(if different E-Mail: thirddayelectricllc@gmail.com
from the Owner listed above) State or County License: EC 2 300 19V7
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN`LAW INFORMATION:`,-
DESIGN ER/ENGINEER:
NFORMATION: :DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 N�Ndto'Tjbtain
Commencement must be rded and posted on t ' bsite
before the f' pe ion. If you in financing,consu it ender or an attorn efo
commenc' w or re rdin r Commencement.
7, 1... "
Signa re of wner/Lessee/Contractor as int fo wrier ?: atur ontractor/License H der
STATE OF FLORIDA r TE OF FLORIDA
COUNTY OF 4C LINTY OF
The fo oing instrum t was acknowledge b fore me Z m- ! forgoing instrum t was acknowledged�before me
this day of 20 Zby C�day of 20 L_L by
w x m
T
PO m P-49 7L
(Name of person acknowle ing) I N me of person acknowl dgi 5
�N
(Signature of tary Public-State of+lorida / (Signature of Notary P ic-State of Florida)
Personally Known OR Pro ced Identi cation ` Personally Known ORrad Identi tion
Type of Identification Produced Type of Identification Produced - `
Commission No. (Seal) Commission No. U (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS