HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
y
COU NT Y
I LORI D A
Permit Number:
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 X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 7704 James Rd. Fort Pierce, FL 34951
Legal Description: LAKEWOOD PARK -UNIT 3- BLK18 LOT15 (MAP 13/14N) (OR 2967-152)
Property Tax ID #: 1301-603-0045-000-5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
I DETAILED DESCRIPTION OF WORK:
Replace broken receptacles indoors; Add receptacle by A/C unit outside as per NEC 2011; Replace
well pump disconnect
CONSTRUCTION INFORMATION:
Additional work toe er orme under this permit - check a appy:
11 HVAC E] Gas Tank Gas Piping _ Shutters ❑ Windows/Doors
ZElectric ❑ Plumbing Sprinklers Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 605.00
S. Ft. of First Floor: _
Utilities: Sewer ❑ Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name L. e-v-9-v�✓,c-
/Ac,`1l,t
Name: rA(LES ROWMgN^-'
Address: -77c)4
Company: fjEU) )EIVb dt- fXk(,T(Li,C-
City:
Zip Code: 3grl S 1
Phone No.
State: j L-
Fax:
Address: SII A))
City: pdtt-l-Awf LLX, t E State: FL
Zip Code: �(qw Fax: 7lZ-HOZ I fI I(aH
Phone No.
E -Mail:
Fill in fee simple Title Holder on next page ( if different
fromthe Owner listed above)
E-Mail.-
-Mail:from
State or County License: E(✓ �Cp� '2Z
If value of construction is $2S00 or more, a RECORDED Notice of commencemeni is requires.
DESIGNER/ENGINEER: _ Not App
Name: _
Address:
City: _
Zip:
Phone:
State:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
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 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 Commencem must be recorded and posted on the jobsite
b^e the first inspection. If you intend to obtain fina .7g nsult with lender or an attorney before
cdmMencing work or recordiniz vour Notice of Commencem t.
as Agent for Owner
STATE OF FLORID STATE OF FLORIDA
COUNTY OF V LU C I � COUNTY OF
The forgoing instrument was acknowledged before me
this day of 20 Eby
Clea r �A oQ p "-P-1A C\
(Name of person acknowledging)
Z) PF-")
(Si re o otary Pat
e of Florida )
Personally Known Produced Identification
Type of Identification Produced
rise
The forgoing instrument was acknowledged before me
this`d day of Pru 20 J by
Com- G�f 2 t'C it� \t�✓��
(Name of person acknowledgin )
re
of Florida )
Personally Known V OR Produced Identification
Type of Identification Produced
y;;,Y • DAV D URKIEWICZ
Commission No.='A Commission No.
': MY CO AeA ION # FF998909
►wa? EXPIRES June 05, 2020
Revised 07/15/2014
53
DAX!Qa�URKIEWICZ
MY COMMISSION # FF998909
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETE
INITIALS
-
_. '
- ' 1,.� � �
._ .•_ _ .. _. ..-._. _ -.
- � I °i_ - ,- i. ' _ ! -fir :�: _ ._ - -
..... ... .. .,_.. - __. _ ..• ._ _ .� .-. ..moi-- ., �.. .. ..
._ .. �•
... ._ >` -.. _. .- .. .. ..._. - .• - - ''.
i '
- T' •! - I
1 rl . - -
- -a 't ; j° i� - -
'r. i .. , .� _ ' .. 1 ,rf 1 ,r -
- �,
- - �-. - �- T
� _ .. t •r- ,
_ _ .i i _ 'fir.
f �'� , -
i
' _
_ •-
._ _ _.. _. �� _ . _.. _ ___ _..
3 _ <... _+.- ... .. _..._
1 H:+ � - rt-. .a 113 r - p t•
r � l �" . sr ? f � ( t-• , _ is , 1v! � f
, � "• i"' - f I� ��..1•
. _.. . �... .a:;_,1<- "' -
' i j/ �t , :�Pr. � _
'
• + •..r. .. �
- �J � .. , .w<-�.. ... -.
� v � f :.r- �
- tl � ,- Ii � , �. J. 1� I •�•:}' �i r .i C. iF • �
7r• L t
Iw'., .. 1. .. 1: • ) y 1 - _ _ --
.._. .: •.x ,+.sic. -.; -.,:.n- - - - ,
1.' K -
�3 }-'l+':�. ,'�Prr -
t -
,f
� 4 f r +; C .'J.
' _
r •� A:- � �^
.`.
K S s`• v C.,{ . L r: @'�.'...
� ; � ..
�.
i' •\ -t 1 •.3 J-. '.. .. �. _ _ _.. -
t ,--:;,:�, ,-�,: ., ,r,'.�. •:.•s 1 •,f;'. •• � "':� -
-'-'-- moi` A "i` � ''_. •✓ •..as �- v' � ..T -
:t' ! "1 ,•1. � •, 1. ! •t••� !`.t�1y ^' _� 1. •) ...-.,
1,}.31.. .•�?:,: :� r _� �-ra,�+ ��:' �. j: �' _ .
t �i,.,_ .. �;'t .3�_r,l ..i�_.3�,. 7.. =. �: Y � ' '
..
1+ ,it_ _ � ;; ,;�__,. ,_ •t t.
.� la„�G-3,- . _ a
-'r _ ��:� +ia ,,�: r? ,t, dr'� r:�l ;r , _,
ti .�,�� '2+,' ► _
1 ,I. •e Ir .. .i -r.
'....•H. -•a .. YAC. ♦ ..3 •. IY.•ir•,.l fr•. .A_..-I--_�_.: �._. �
F t r -t _ -
i,w.•1.�w ..•. ••.f l.-. ri-Y3".9 ti. 33L- _
A - '. i. ?.: n r _ ;`•' .. ,;=f +
��•ti'-J:._ .ti CJI 'aT[. .�T.t-•:6^'t •••_•.'rt'+N•t.4yC�w _.4�„ YL'11i•-t_.
♦_r t .T. iN
• � -
..: 3•+.•Q�+-.-.'l��-:>risw_ :t