HomeMy WebLinkAboutBuilding Permit Application i
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: (XQ '(A9 IS
-_ - BuildingA '
Permit Application
on
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
PfOPOSED IIUIP01/EMENT LOCATION ; 5
�. „s
2405 N 45th St. Fort Pierce, F ����.
Address: L 34946
Legal Description: HARMONY HEIGHTS AD DN BLK H LOTS 20 AND 21(OR 507-2067:SEPARATION AGRMT RECORDED IN INDIAN RIVER COUNTY#1158 FR 01 DATED 11-3-92COPY IN FILE)(OR 1314-1923)
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Property Tax ID#: 1431-701-0126-000-8 Lot No.20&21
Site Plan Name: Block No. H
Project Name:
Setbacks Front Back: Right Side: Left Side:
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DETAILED DE CRIPTI, ;' b WORK g
p a a 1a s
install 1 aluminum storm panel over existing opening
CONSTRUCTIIJN91NFORMATIO,N,.
.. H ...f _
Additional work toe e orme un ert ispermit—checka appy:
HVAC Ei Gas Tank ❑Gas Piping _Shutters a Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction:$ 1171.00 Utilities. _Sewer[]Septic Building Height:
OWNER/LESSEE CONTRACT®Ri r
i ,
w
Roy Thomas Raquel Swanner
Name Y Name: g
Address:2405 N 45th St. Company: The Home Depot
City: Fort Pierce State:FL Address: 6500 NW 12TH Ave. Suite 110
Zip Code: 34946 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.
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SUPPLEMENTALnCONSTRUCTION LIENLAW I �ORMAT(QN g � r
.,
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 osted on the jobsite
before the first inspection,Uou int d to obtain fina ult with lender or attorney before
com I work or r r otice of Co encement.
Sig ature n Les Sig ature of Contrac or/License Holder
STATE 61F FL RIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before The for oing instrument was acknowledged before me
me this�day of �w 20 17 by this 1 day of v n t 20_17 by
1 �`Ad`�n,.t�\ SvoB�ln+v2� �ALi1� S,�aV.✓ra�
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
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)
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: C-1 �� IVifri,et cO1 MY CsMMIISSION#FF L142794 ;�l
EXP REG:August 7 2017
XAugust 7,Zaii Footled Thru Notary Public Undenvriters 07/15/2014 Ffi7E£:
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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