HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED `
Date: 02/04/2017 Permit Number:
•
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 x
PERMIT APPLICATION FOR: Ee
PROPOSED 111\4PROVE MEW LOCATION:
Address: 4101 South Indian River Drive, Fort Pierce, FL 34982
Legal Description: 35 35 40 S 100 FT of N 440 FT OFE 1/2 OF NE 1/4-LESS RD AND FEC$$-(3)(OR 586-2158:849-177:874-1548
Property Tax ID#: 2435-111-004-000-1 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION 'O'F WORK:
A k�ain link-fence-per-rough-layout attached. �- �od A(e- , 2-
'CONSTRUCTION
CONSTRUCTION INFORMATION:
Additional work to be nerformed under this permit—check all appy:
HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
11 Electric Plumbing U Sprinklers FIGenerator E] Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 2475 Utilities:n Sewer D Septic Building.Height:
OWNER/LESSEE: CONTRACTOR
Name Thorwelhaven t1 UW— Name: N 14
Address:4101 South Indian River Drive Company:
City: Fort Pierce State:FL Address:
Zip Code: 34982 Fax:7724612170 City: State:
Phone No.7724611558 Zip Code: Fax:
E-Mail:thorwelhaven@bellsouth.net Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x 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, consult with lender or an attorney before
comm,pncing work or recorclik your Notice of Commenceme t.
Sig atu of 0 ner/Lessee/Contractor as Agent for Owner Sig to a of Co tractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA<4 L,UC, (2—
COUNTY OF Lk) COUNTY OF
The for oing instrument was acknowledged before me The for oing instrument ryas acknowledged before me
this Y day of FP�j 20 aby this Y day of r2 /� 20 L2by
�Yaw L�)Jde_s -1- W/f �yc�qq'
(Name of person acknowledging) (Name of person acknowledging)
(Signature of ary PubIlice State of F rida) (Signa re o Nota Pu bl' -State of Florida)
Pers wn d entification Personally OR Produced Identification
Typ ca Me onig Type of Id t' ' ti ro uh'6 HERhbifl
•... Boded Th yotagt Pubic ur ery ry '.; ;:= MY COMMISSION#FF 920640
Com eal) Commissi EXPIRES:November 18,2� a
.P,, oededThruNotaryPubicundewhrs
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS