HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: i d 1� �'� Permit Number: \`t 16•d(15
RECEI` 7D OCT 112017
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 xx
PERMIT APPLICATION FOR: Concrete
PROPOSED IMPROVEMENT LOCATION:
Address: 179 VINDALE AVENUE
Legal Description: Lot 17,Stock 3,BEL-AIRE ESTATES,according to the Plat therof,as recorded in Plat Book 14,Page 21,Public Records of SL Lucie County,Florida.
Property Tax ID#: 1312-701-0044-000/3 Lot No. 17
Site Plan Name: Block No. 3
Project Name:
Setbacks Front 25' Back: 10, Right Side: 10, LeftSide: 10,
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
Additional work toe Derformed under this permit—c ec all that appy:
(
HVAC LJ Gas Tank ❑Gas Piping _Shutters a Windows/Doors-
13 Electric F-1 Plumbing Sprinklers 11 Generator Roof Roof pitch
Total Sq.Ft of Construction: SCI. Ft.of First Floor:
Cost of Construction:$ qSO .00 Utilities:11 Sewer F�Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name TRACY HOCHENDONER Name:
Address:188 IMPERIAL WAY Company:
City: FT.PIERCE State:FL Address:
Zip Code: 34951 Fax: City: State:
Phone No.772-777-1363 Zip Code: Fax:
E-Mail:tliseacs718@gmail.com Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name:TRACY HOCHENDONER Name:
Address:179 VI NDALE AVENUE Address: 188 IMPERIAL WAY
City: FT.PIERCE 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:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
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
commerKing work or recording our Notice of Commencement.
Signature of Owne /Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 4k_ Lyt.%.e COUNTY OF
The forgoing instrument was acknowled ed before me The forgoing instrument was acknowledged before me
this day of CS C' 20AI by this_day of 20_ by
Name ck person making statement Name of person making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public-State f (Signature of Notary Public-State of Florida)
ri b���"—�—g' D�NNA�JARIE GIVE14S
Commission No. •�<t�o M•(COMt #GG 022023 Commission No. (Seal)
= : EXPIRES:December 16.2020
'ON ru Plotary Public Underwdters
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17