HomeMy WebLinkAboutBuilding Permit Application.A a
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
r
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34582
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
I'ROPOWP If�+'[�'RC+1f 111 1 TL CATt N "
Address: V1410 i 1 I 'P r� !'G-.; Aica 31l q o
Legal Description:
Property Tax lD #; �� f "' ( "t r �' Lot No.
Site Plan Name: r�� Block No.
Project Name: CA KTA
Setbacks Front Back: Right Side: Left Side:
CONSTRUCTION WFORMA ONO:
Additfanai work to be nartormed under
11 HVAC Gas Tank
`� Electric i� Plumbing
Total Sq. Ft of Construction: 400
Cost of Construction: $ /] ®4Q
this permit - check all that apply:
E]Gas Piping _ Shutters I__1 Windows/Doors
OSprinklers Generator 11 Roof
S Ft. of First Floor:
Utilities:nSewer Septic Building Height:
E -Mail:
Phone No. 77a- 370--.S-7S�
Fill in fee simple Title holder on neat page ( if different E -Mail: D C.✓P-&A- JCk[ @ A-7 MJF 1
from the Owner listed above) State or County License: le C.03(a _30-7a
If value of construction is $2500 or more, a RECORDED Notice of Commencement Is required.
DESIGNER/ENGINEER:
OWNER/
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.-
hone:
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 an€t 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
obtain financinconsult W' h tender or an attorney before
coommenc f I work orae n• I y
Irg vo r Notiou intend tcfinancing, consult
of Commencement.
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Lessee
STATE OF FLOWA(?�p
COUNTY OF y71/ „l
The forgoing instruglent was acknowledged before me
this ,day of - 2p�by
��n
(Name of person acknowledging)
(Signature of Notary Public- State of Florida 1,,
Personally Known c/ pR Produrl.��ss
Type of Identification Produced a� Qo�L�d�'.C'r`
Commission No. `fFi'/9� ; (Sealr•�
Nom ; #FF048182
ZNIS
/ t9
REVIEWS FRONT ZONIN'�ry�� STM 1�ISOR
COUNTER REVIEW IEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 7/2014
signatul'4'of Contr or/License Holder
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this /5 day of ;Z/ • 20ZZ by
Te
(Dame of person acknowl' dd ging )
(Signature of Notary Public- statof Flo�i 11111fiA��p
C�. ViAGiCf��`y
Personally Known OR Pro�;iefitn
Type of Identification ProducedQ
Commission No. t� �l/yam �* : Str
#FF 0481.92 � : Q
&.ndev 411
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PLANS VEGETATION SEA,NGROVIr
REVIEW REVIEW REVIEW REVIEW
I
Arthur Engelmann lk Licensed & Insured
ECO003072
CURATE
ELECTRICAL. CONTRACTING
Offlce: 772$78-9171
Fax: 772-878-2854
Ema1I:dcvranch@atLnet
7183 Gullottl Place • Port 5t. Lucie, FL 34852
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Arthur Engelmann Licensed & Insured
ECO003072
CURATE
ELECTRICAL CONTRACTING
Office. 772-878-9171
Fax: 772-878-2854
Emall:dcvranch@att.net
7193 Gullot#1 Place • Port St, Lucie, FL 34952
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