HomeMy WebLinkAboutBuilding Permit Application ALL APPLICAB E INf0 MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I a`ti �7 Permit Number:
E; a a
Building.Permit Application ®V 2;g. 2Q17
Planning and Development Services `'
Building and Code Regulation Division `'Public Works
2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie County, FL'
Phone:(772)462-1553 Fax:(772)46271578 Commercial Residential x .
PERMIT APPLICATION FOR: Concrete
PROPgSED INIPR0VE11�IEIT LOCATI'ON4 _ fi
Address: 9 Vo
��•9ec FL 3q5s
Legal D.escription.:.See Survey Attached with Legal Description
Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name: Kuhn Res
Setbacks Front 0 Back: +1-44ft Right Side: +/-5ft Left Side:+/-164ft
.DET�IILED D�SCR1PTtC++I�)pF 1NORK, � `� ~
Install Concrete Driveway with 4"thick concrete. 3000psi Fibermesh conc.typ see plan attached.
NO FOOTER.
CONSRUCTl0N (NFORN1ATlON _
_ l Y .o. _.
AdditionalWorkto �e orme under this ermit—checkall apply:
HVAC Gas Tank FIGas:Piping Shutters Windo
❑ ws/Doors
Electric F Plumbing Sprinklers Generator Roof Roof pitch
Total Sq.Ft of Construction: 860 Sq. Ft.of First Floor:-860
Cost of Construction:$ 2000 Utilities: Sewer mSeptic Building Height:•NA
UIrNER/LESSEE fi CONTRACTOR Y t
�,
Name 'KA.4(_ kqdly Name: H '.
Address: q I LV Co JLEY f-de' Company: Heritage Contracting Services Inc
City: rt 196p,e State:FL Address: 56 A), S f
Zip Code: 34951 Fax: AJ 11A City: �. 3 t'R�Gc'. State:FL
Phone No.772.216.6612 Zip Code: 34946 Fax: N IlY
E-Mail:paul.k.hcs@gmail.com Phone No. 772.216.612
Fill in fee simple Title Holder on next page(if different E-Mail: paul.k.hcs@gmail.com
from the Owner listed above) State or County License: CGC1507158
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
UPPLEM£NTAI_CONTUGTIt�Nx L1i� LA1�U iNQRIATt(�i1 �
DESIGNER/ENGINEER: x_Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEESIMPLE TITLE HOLDER: 6 Not Applicable BONDING COMPANY: 24 of 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.^ArT�R Tr'ff �Tc"Jin'1�: s�Pf,
St.Lucie County makes no representation that is granting a permit will authorize thepermit holder to build the subject structure
which is in conflict with any applicable-Horne 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.
Thefollowing 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 obtainfinancing,consult with lender or an attorney before
cornmencing work or,recording your Notice of Commencement_
Signature of Owner/Lessee/Contractor-as Agent for Owner SignatureContractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA �
COUNTY OF ('11iCOUNTY OF rlI • GLCLc-
The f r ing instrume t was acknowledged before me The for ing instrumentwas acknowledged befoee,me
thi day of IV V V 2011 by this day of A/&V .20-a by
Name of persopmaking statement Name of perso�n aking statement
Personally Known V OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of tary Public-State of Flori a) (Signature of N t ry Public-State of Flori a)
Commission No. (Seal) Commission No. (Seal)
REVIEWS, FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
A DREY B
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UMPHREY -�•r �:':apAUDREYB.HUMPHREYMY CUMMISSIN#FF 20192Y PL'EXPIRES:Mrch 6, *; MY CUMP11SSiUN#FF 174772
'4 PubficUnda.ners ^' EXPIRES:IVlaroh 6,2019
'V o' Bonded Thru Notary ' :- ?P�=
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,od jhl ''of °,• Bonded Thru Notary Public Underwriters
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