HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
CQCINTY`
L- O R [ D Pi
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: To Select from dropbox, click arrow at the end of line
_I PROPOSED IMPROVEMENT LOCATION:
Address: 8165 BUCKTHORN CIR
Legal Description: SAVANNA CLUB -PLAT ONE- BLK 4 LOT18 (OR 489-795-.841-1888-.3465-1234)
Property Tax ID #: 3425-701-0111-000-7
Site Plan Name:
Project Name: Korpalski
Setbacks Front Back: Right Side: Left Side:
J DETAILED DESCRIPTION OF WORK:
Remove existing panel and replace with a Square D QO 150 AMP main breaker
=I CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit —check all that apply:
Lot No. 18
Block No. 4
HVAC L_I Gas TankGas Piping Shutters a Windows/Doors
ZElectric ❑ Plumbing Sprinklers I Generator Roof L� Roof pitch
Total Sq. Ft of Construction: 1352 S. FtFtj, of First Floor:
Cost of Construction: $ 900 Utilities: nSewer Septic Building Height:
OWNER/LESSEE:
Name Korpalski
Address: 43672 Hanover Ct
City: Canton State: MI
Zip Code: 48187 Fax:
Phone No.
E-mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: Donald B Green
Company: Don Green Electric
Address: 1305 W 1st Street
City: Fort Pierce
Zip Code: 34982 Fax:
Phone No. 772-418-5739
E -Mail: dongreenelectric@gmail.com
State or County License: ec13007447
If value of construction is $2500 or more, a RECORDED Notice -of Commencement is required.
State: FL
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
State
X Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
X Not Applicable
State:
X Not Applicable
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
commencing work or recording your Notice of Commencement.
lieOQ-2--v
Signature of Owner/Lessee/Contractor as Agent or Owner Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF K-& l
Theoing instrument was cknowledged before me
this day of FAn C- , 20 ('1 by
Personal
Type of I
K_ OR Produced Identification
Produced
Commission No.-�—_F q ` C) W.I)
Revised 07/15/2014
REVIEWS FRONT
COUNTER
DATE
COMPLETE
INITIALS
JOY CHRISTINE COPELAND
MY COMMISSION #FF948042
EXPIRES: JAN 05, 2020
°.. Bonded through 1st State Insurance
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this AL day of " ct ri!-�-- 20 l 1 by
0, C'e-p'sJ
(N a ooffsNotary
acknow dging )
P
{Sig tuPublic- State of Flo da )
Personally Known OR Produced Identification
Type of Identification Produd
commission No.
cl4 ff�2
ZONING SUPERVISOR PLANS
REVIEW REVIEW REVIEW
O1�xV PUB` JOY CHRISTINE COPELAND
?' MY COMMISSION #FF948n42
EXPIRES: JAN 05, 2020
Bonded through 1st State Insurance
VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW