HomeMy WebLinkAboutbuilding Permit ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit dumber:
Building Permit Application
Planning and Development Services
Building and Cade Regulation Division
2300 Virginia Avenue, Fort Pierre 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
PROPOSED IMPROVENIEIVT'LOCATIO .
Address: 13480
Legal Description:
Property Tax ID 36— ,5-- 0010 ON-0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRI.PTIO"N OfT 111fQRI�:
R,gPi AcF_ Cx qt usi FA-A)_) 4bb CA-AJ JA) 5 WC W� TIC S IiT .
�L_hCE E.-ls-IAIC s U)J_rC,46_S p I L4�;?_S 3 '4a) VAAJI 7-�/ I.IC 11 r
CONSTRUCTION INFORMATION
Additional work to Ifflo-W—med under t ispermit-check all tha apply:
11 HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
177-1
Electric Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
�,�e�.�1�O
Cost of Construction:$ l.�J Utilities: . Sewer USeptic Building Height:
OWNER/LESSEE:. CQIVTRAC TOR:.
Name Name: AKTU09, A]
Address: IC' ., Ae V6 Company: I o g&-re cy,)c/-1 &AILP,F4C7/N6 !,(,rC
City: I E,2n� PR inlet State: J l` Address: ?i 3 (��l ;(�� —
Zip Code: Fax: City: P��1 � 'Lor-tE State: FL
Phone No. (7 -�f? 1 Zip Code: 3 475a Fax:
E-Mail: Phone No. 7731-370 ._s7S,5'
Fill in fee simple Title Holder on next page(if different E-Mail: r)CV'k&rJQq @_ R7. NET
from the Owner listed above) State or County License: l-C aC 307
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required_
DESIGNER/ENGENEER: 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:
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 Count 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 st inspection. If you intend to obtain financing, consult with lender or an attorney before
comme jug work or pecording your Notice of Commencement_
Signature of Ow r/Agent/Lessee Signature of Contrac License Holder
L R STATE OF FID,, ? = STATE OF FLO IDpy+
COUNTY OF
y, COUNTY OF----1d
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of �. �� 20by this %"day of ��Qn-� 2Q 6y
(Name of person ackn edging) (Name of person acknowledge )
(signature of Notary Public-5t e of V� ►lilr�� (Signature of Notary Public-Stat o,�4 �.:.•.X.
,jC!ri
Personally Known_ E3R P` lu t{�pn Personally Known OR PrAu I�
Type of Identification Produced= �� �e� �o�t S Type of Identification Produced
Dgg,�
Commission No. FF�`� /S��Z=�• g2 �Q Commission No. r/� bI L7 y�'• eaf, •.��
7REV1=EWREV11EVW
tiREVIEWS FRONT SOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
Arthur Engeimann Licensed& Insured
EC0003072
ACCURATE
ELECTRICAL CONTRACTING
Office:772-878-9171
Fax: 772-878-2854
Email:dcvranch@att.net
7193 Gullotti Place - Port 5t.Lucie,FL 34952
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