HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED n/
Date: Permit Number: rl 09 YO
RECEIVED
Building Permit Application SEP 15 2017
Planning and Development Services PERMITTING
Building and Code Regulation Division St. Lucie County, FL
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 �173�7
PROPOSED IIUIPROUEMENT LOCATIONs:t { �
Address: 5510 Echo Pine Cir. E
Legal Description: Holiday Pines S/D-Phase 1-Lot 121 (Map 14-07S) (OR 1324-2763)
Property Tax ID#: 1312-500-0122-000-7 Lot No.121
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
�DETAILEO DESCRIPTIONQF WORK' x
replace 7 windows size for size
Additional work to be performed under t ispermit—c ec a appy:
HVAC Gas Tank F_]Gas Piping _Shutters Q Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of,Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 6381.00 " Utilities: Sewer ElSeptic Building Height:
DUUN ERESSEE � " CONTRA AOR
r�,,,
Name Lori Lang Name: Raquel Swanner
Address:5510 Echo Pine Cir. Company: The Home Depot
City: Fort Pierce State:FL Address: 6500 NW 12TH Ave. Suite 110
Zip Code: 34950 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.
SUPPLEMENCONSTRUCTION LIE
TAL N LAW INFORMATION'
i44
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 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 first inspection. If you intend to obtain financing, consult with lender or an attorney before
com cln rk or recording o N ice mmence
Signature of Owner/Agent/Le see Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before The forgoing instrument was acknowledged before me
me this 7 day of AA , 20 17 by this `1 day of A,. 20_17 by
(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)
.•� ".:� TIMOTHY R.O'MALLEY r:y
,,.•��: �;,, TIMOTHY R.O'MALLEY
.; LMMY COMMISSION#UG 117135 a; ;# MY COMMISSION
Revised 07/15/2014 EXPIRES:August 7,2021 EXPIRES:August 7,2021
'•.FOF ;••' w
Bonded ThN Notary Public Undenxrilers '•';oFF�:•`' Bonded Thru Notary Public Underwriters
u.•
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS