HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR'APPLICATION TO BE ACCEPTED e
Date: G Permit Number:mi WP
_ ` ; i
RECEIti r._D JUN 12 7.017
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
P, SED,IMt'RO\lEMENT LOCATION
Address: 5511 Birch Dr.
Legal Description: Indian River Estates-Unit 08-Blk 56 Lot 33
Property Tax ID#: 3402-609-0171-000-1 Lot No.33
Site Plan Name: Block No. 56
Project Name: Morin- 10077591
Setbacks Front Back: Right Side: Left Side:
DETAILED DEaCRIPTI( 1 C?F 1l4TORK
replace 9 windows size for size
CO tSTRUCTto INt=ORMATION
Additional workto e nertormed under tis permit—check all appy:
HVAC Gas Tank Gas Piping _Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 13302.00 Utilities:n Sewer 0 Septic Building Height:
011UNER/LESSEEff
,6042
x CONTRACTORt� S p
M
Name Daniel Morin Name: Raquel Swanner
Address:5511 Birch Dr. Company: The Home Depot
City: Fort Pierce State:FL Address: 6500 NW 12TH Ave. Suite 110
Zip Code: 34982 Fax: City: Fort Lauderdale State:FL
Phone No. Zip Code: 33309 Fax:
E-Mail: Phone No. (754)224-2010
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: CGC1514813
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
$U;PPLENiENTAL CQNSTRUCTIQN L1tN LAW 1N ORMATIO x „s 0-
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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 thepermit 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 ' nd to obtain financin sult with lender or an a orney before
c work or r in our Notice of Comm ement.
Signature r t/ essee Signature of o racto /License Holder
STAT F FLORIDA STATE OF FLORIDA
COUNTY OF 5t- L\Ae_i4__ COUNTY OF Lit_U_
The forgoing instrument was acknowledged before The forgoing instrument was acknowledged before me
me this 4> day of 20 17 by this d day of ,tn w" ,20_17 by
1�tA.e.� �kwn.s� �a q�.� �w A.y.,✓ve�,(
(Name of person acknowledging) me of person acknowledging)
` y:',a'• TIMOTHY R.O'MALLEY
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F
TIMOTHY R.C`MALLEY
=q',. 'P'= MY COtoiMISSION#FF 042
'., MY CObiMlSSION#FF 04279 e+: ;__
1 = EXPIRE6:August 7,20
EXPIRE6:August 7,2017 n Nnta. Public Urda• ers
t r�
(Signature of Notary Public Ste pf Florida - -- --- nature of Notary Public-State
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. (Seal) Commission No. (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
CO M P LETE
INITIALS
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