HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED t
Date: . Permit Number:
. ._ RECEIVED FEB 0 B 2017
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 Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line q
PROPOSED NPROVEMENT LOCATION:
Address: 3009 APPAMCN SPOT Wi9 y
Legal Description: LIAIXS AT SAVAAIA/A CZUB (PB '10-39) TRK L07 o2a
COR 1756 -- %0 8d)
Property Tax ID#: 3 4 a 5'" 761- Oa 03 - z9o0- 7 Lot No.
Site Plan Name: WOLF'AAM Block No.
Project Name: WOLFIZ14M
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION .QWORK., `.
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f}JC CH/?A1G6'-00T- 'T�M!'g -1' g PfickAiGE UNl'T- 14 S,!FYA 3.5 770 At
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CONSTRUCTION IIN<FORMATION
Additional work to be performed under this permit-check all appy:
HVAC L__I Gas Tank Gas Piping _Shutters Windows/Doors
Electric Plumbing OSprinklers Generator F] Roof Roof pitch
Total Sq. Ftof Construction: S Ft. of First Floor:
Cost of Construction:$ 143-75, 00 LitilitiesInSewer 11 Septic Building Height:
m
OWNER/LESSEE.: CONTRACTOR:
. . ._
Name r1R. POLF in X,- Name: HARK A VI NES
Address: 3 DO444 sir (447 Company: A:Z TI L
City: JOS L State:r-:�l Address: a 5 U S /L!!L l Ti4 R Y TR
Zip Code: 3 g9S3 Fax: City: OJE-ST PfiLM 8E f4Ca State: FL-
Phone
LPhone No. -7P - 9 �('3 - qqa? Zip Code: 334/S Fax: 5(a/- 43 Jz- 00/,?
E-Mail: Phone No. 561- 43 6- 9,/ 97
Fill in fee simple Title Holder on next page (if different E-Mail: PE-RHI T sG f3ZT I C nG - C-61-1
from the Owner listed above) State or County License: C A C 0 4'9 a53
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SU'PiPlL;EMV ENTAiL,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: _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 Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, c9Pr5MFwith lender or an attorney before
comme,pcog work or recording our Notice of Commence nt.
s
Signature of Owner/Les a/Contractor as Agent for Owner Signature of Contractor/Li ense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTYOF PAUM )3VICH COUNTY OF PP-LM 13ElqCN
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 94 day of Tn A/U/3AY 20 1_7 by this A day of T HA1VfiAy 20 /7 by
N/M�k P V/iv 6- hlf q K A Vlx/CS
(Name of pe acknowledging (Name of person acknowledgin
/Pernally
of Notar b'c-State of Florida) (Signat re of Not lic-State o a
K w OR Produced Identification Pe on Kn wn OR Produced Identification
entificati n Pr Type of Identi icat'
` `4
PV JOHN EDWARD ?SPPV P`B[ JOHN EDWARD:=0 4�<
Commission No. :•€ MY MISSION#FF077427 Commission No. MY COMMIS {�FF077427
, EXPIRES December 17, :�..
j 2017 "'?i'- AP�q' EXPIRES December 17,2017
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