HomeMy WebLinkAboutBuilding Permit Application :ALL APPLICABLE INFO MUST BE COMPLETED,,F911PPLLCATION T.O.BE ACCEPTED
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Date: AN 1Permit Number:
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R E C E I D.AUG LM-0-1-mi halga1 2017 -
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- - - Building.Perlmit-Application
Planning and Development Services'
Building and Code Regulation Division
2300 Virginia Avenue,--Fort Pierce FL-34982
Phone:-(772)-462=1553---Faxc(772)462=1578--- to—m 1lerCial- - -- -ReSidentiBl
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'PERMIT APPLICATION-FClR: `
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PROP.S IMPROVEMENT LOCATION
Address:. 3: , d -.G'�7, l P-6 . ,,VE-: ..;.,t. ; '.!: t
Legal Descrip#idri: = '''•; .+, v , ° _ .',,�;.t, ..
.ti r _ :'A a !y ,!tii ! , . t f'?r.._ , ..:t`,' �:'_ r•J .: ♦%z ..a.� _ to,.• , r 1' J,_ ,
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Property Tax ID#: ,14 . .E .rte U:2, G( D D;,,—,,.0 rU '�.,:-y;.,c•' i_, Lot No.
Site Plan Name: Block No.
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Project.Name: ,C;1, i.; I, <r,,,. : .,,•,;,,
_ Setbacks Front Backe' Right Side:'J11 eft Side
DETALLED DESCRIPTION,OF WORK
CONSTRUCTION INFORIVIATI'ON
itiona wor to e erformed under this permit—check,a appy:
C�HVAC -' Gas Tank ".: .' GasPiping--- Shutters- QWindows/Doors
llect'r`ic " Plumbing' -' Sprinkler's' E Generator ERoof C'Roofpitch
Total Sq. Ft of Construction: S . Ft.of First Floor: ='
Cost of Construction:$ CDS Utilities: Sewer 0Septic Building Height:
01NNER%LESSEE rx ',CONTRACTOR Y
Name 2 S;T'.', Y{-' Nam2` KENNETH F.CONWELL
`' `
Address: 1 q•g i-p.Com �1�;� =(� �t —T Company: CONWEL'L 8�'ASSOCIATES CONSULTING COMPANY
City: :.�b�a� 'SI�'t State:.f Address: 11771 SW 137 PLACE
Zip;Code:,?,(U�-1 Fax: „ City,MIAMI ' r,.- State•FL.
Phone' � "' ' Zip Code: 33186 ,+f ,,. Fax:,305-385-7827
E-Mail: V Q, Qyyka i Cym Phone No. 305-926-5673
4
Fill-in fee simple Title Holder ori next page(if differerit - E-Mail: kconwell@caconsultingc.com
froi)..the Owner.listed above) _ "__ State or County License: CF61428047
51,
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION'LIEN LAW 1,NFORMATION . t `
DESIGNER/ENGINEER: =t Not Applicable MORTGAGE COMPANY: Not Applicable'
Name: Name:KENNETH F.CONWELL
Address: Address:
City: State: City: MIAMI State:
Zip: Phone : `F: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name: -77
Address:1177,sinr137 PLACE Address:
City: -, _ . city: `
Zip: Phone: Zip: - Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to,do the work and-imtallation as indicated.
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-,
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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 l 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:-YdUt1ailure to'Recded a Notice of Commencement may fesult in your paying'twice for
improvements to you r_property.A_Notice of Commencement must.be_recorded.and posted on the-job'site
before the first inspection. If you intend to obtain financing; consult with lender or an attorney before
commencin work or recording our Notice:of Commenceme — -
Signatuy of Owner/Lessee/Contractor as Agent for Owner Si_g'Nata of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF--- COUNTY OF-----
The forgoing instrument was acknowledged before' me The forgoing inttrument.was acknowledged before me
this 11 day of AUGUST ,2017 by this >> day of AUGUST 2i by'
Nam e..of-person making statement Naryie,-of person making statement
Personally Known xx OR Produced Identification Personally Known xx OR Pr-oduced4ldentification
Type of Identification Type of Identification " -
Produced Produced
Si nature Nota Public- to of Florida
(Signatu a of Nota _ 't -' eLV rX%)#' GG001091 ( g ry tat
Caro yn M.Comvell
Commission No. GGo&� Q=-Expires: ber,7,�2020: ;.F P
Commission.No.. Colnnifted) # 1313001091'
%D �� Bonded,thru: aron Notar�r_ = '�= Expire
. .,,, - o _s: October 7, 2020
Bonded thru Aaron Notary
REVIEWS' --FRONT---- ZONING -- SUPERVISOR- PLANS VEGETATION 'SEATURTLE. - MANGROVE''
COUNTER REVIEW '` REVIEW, ;..; .REVIEW REVIEW REVIEW REVIEW,.
DATE - - - -- -
RECEIVED
DATE
COMPLETED
Rev.8/2/17 _