HomeMy WebLinkAboutBuilding Permit ApplicationDESIGNE
Name: _
Address:
City:
Zip:
ENGINEER: Not Applicable
Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
State:
Not Applicable
MORTGAGE COMPANY:
Name:
Address:
Citv:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
Citv:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
Not Applicable
State:
Not Applicable
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 vour Notice of Commencement.
F
re OwrSer/ Agent/ Lessee
STATE OF FLORIDA
COUNTY OF 5/ LtAr-u-
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF 9 - t VC i e_
The forgoing instrument was acknowledged before The forgoing instrument was acknowledged before me
me this day of D� 20 17 by this day of i'�� , 20_17 by
gTIMOTHY R. O'MAL
Name of person acknowled in v of person acknowledging) b' D °° j,m MY COMMISSION #GG 11
( p g.4n NiY COMMISSION # GG 117
-
y= EXPIRES: August 7, 20',
EXPIRES: August 7,20:1
Bonded Thru Notary Public Und � wri'tels �, 09,t,y90Bonded Thru No .ry Public Unde
a
(Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida )
Personally Known x OR Produced Identification
Type of Identification Produced
Commission No.
Revised 07/15/2014
(Seal)
Personally Known x OR Produced Identification
Type of Identification Produced
Commission No.
(Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
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
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED I=MPROVEMENT LOCATION:
Address: 2390 S Brocksmith Rd.
Legal Description: Subdivision of McNurlen Farms Blk 1 Lot 7
Property Tax ID #: 2320-501-0007-000-6
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
replace 4 windows and 1 door size for size
Lot No. 7
Block No. 1
lditional work tobe Off
under this permit — check all t at apply:
F]Gas Piping 0_ Shutters
Windows/Doors
HVAC Gas Tank
_
❑ Electric ❑ Plumbing
Sprinklers
FIGenerator
F]Roof
Total Sq. Ft of Construction:
Cost of Construction: $ 8176.00
Name Kjartan Valdimarsson
Address: 2390 S Brocksmith Rd.
S. Ft. of First Floor:
Utilities: _ Sewer F]Septic
City: Fort Pierce State: FL
Zip Code: 34945 Fax:
Phone No.
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: Raquel Swanner
Building Height:
Company: The Home Depot
Address: 6500 NW 12TH Ave. Suite 110
City: Fort Lauderdale State: FL
Zip Code: 33309 Fax:
Phone No. (754) 224 - 2010
E -Mail:
State or County License: CGC1514813
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.