HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO rMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1T�� 1' I I Permit Number:
r--
Building Permit Application NOV 2 7 2017
Planning and Development Services PEE R�4IITi NG
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 X
PERMIT APPLICATION FOR: Demolition
PROPOSED IMPROVEMENT LOCATION:
Address: 14313 Dulce Real, Fort Pierce, FL 34951
Legal Description: Pacel ID 013337
Property Tax ID#: O�n. ( t ` . � � ) Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Demolition of Added Back Porch
��I Ic r 1 C4 j]"o , �Y-M n �� - __7
CONSTRUCTION INFORMATION:
Additional work toe performed under this permit—check all appy:
HVAC Gas Tank ❑Gas Piping _Shutters a Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: 285 Sq. Ft. of First Floor:
Cost of Construction: $ 1600 Utilities: Sewer 0 Septic Building Height: 8ft
OWNER/LESSEE: CONTRACTOR:
Name Paul or Lillemor Zimmerman Name:
Address:14313 Dulce Real Company:
City: Fort Pierce State:FL Address:
Zip Code: 34951 Fax: City: State:
Phone No. Zip Code: Fax:—
E-Mail: 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: 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:
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
commencing work or recording our Notice of Commencement.
Sig ture Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLO I STATE OF FLORIDA
COUNTY OF COUNTY OF
Thef rg ing instrpment was acknowledggd before me The forgoing instrument was acknowledged before me
thisay of e/ 20� by this_day of 20_ by
Paul L, 2;m rn'er-arta n
Name of pe rso aking statement Name of person making statement
Personally Known L OR Produced Identification Personally Known OR Produced Identification
Type of Ide tification Type of Identification
Produced ra. b( -e /1 Produced
9 '310 -79
ignature of N rye ,State o#WRMI N E7VANS of Notary Public-State of Florida )
r•�; `�s� NM�ry Publk-atat�W fiorid�
Commission No. Commbt(�llff 913652 Commission No. (Seal)
My Comm.Expires Ep 6.2019
.F�a i ���, 6axMd ft01�1(M1011r Icy SII.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17