HomeMy WebLinkAboutBuilding Permit Application I' ;r
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED i i
Date: Permit Number: 11qo1_C)4q?l
Building Permit Application
Planning and Development Services !!
Building and Code Regulation Division I'
2300 Virginia Avenue,Fort Pierce FL 34982 I
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x
PERMIT APPLICATION FOR:
Mechanical
PROPOSED IM VRC?U ME'`NT LQCATI.QN „ �1
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Address: 3705 fetterbush ct
Legal Description: '
Property Tax ID#: 3425-706-0021 Ir I' Lot No.9
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Site Plan Name: ! I Block No. 45
Project Name:
Setbacks Front Back: Right Side: Left Side:l' I '
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DETAILED QESCRIt?TION OF 1t1%ORK
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CONSTRUCTION INFORMATION a' �'
itlona wor to e e orme under tispermit—check all appy:
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HVAC Gas Tank 0Gas Piping _Shutters iI Qi Windows/Doors
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Electric ❑_Plumbing Sprinklers ElGenerator I `-Roof Roof pitch
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Total Sq. Ft of Construction: S Ft.of First Floors 1 I
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Cost of Construction:$ Utilities: Sewer SII ptic Building Height:
OWNER/LESSEE°owner " x" CONTRACTOR
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Name William gessner Name:
Address:3705 fetterbush ct Company:
City: part saint lucie State:fl Address:
Zip Code: 34952 Fax: City: li I J State:
Phone No.631-295-0358 Zip Code: i Fax:
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E-Mail: Y9 @ P Phone No. I� '
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 riiquired.'
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SUP LEMON�LI N�LAIN INFaRMATIC?N
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: i Not Applicable
Name:William gessner Name:
Address:3705fetterbush ct Address: 3705fetterbushct
City: portsaintlucie State: City: i State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: I Not Applicable
Name: Name: 'd I
Address: Address: II '
City: City: i!
Zip: Phone: Zip: Phone:
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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 thepermit 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 6111 respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments. i
The following building permit applications are exempt from undergoing a full concurrency review;room aldditions,
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 resukin 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 qr; an attorney before
commencing work or recording our Notice of Commencement.lt4 !
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Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/Lice rise Holder
STATE OF FLORI A STATE OF FLORID
COUNTY OF � \Up� COUNTY OF `.�Mla0l .
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The forgoing instru ee t was acknowledge before me The forgoing instru t was acknowledged before me
this�day of 'Szxw 20T& by this �a day of !'i 20 by
1�\\CIP W N\\\Cry\ P}�
Name of person making statement / Name of person making statement /
Personally Known OR Produced Identification C/ Personally Known OR Produced Identification f/
Type of Ide tific, tion Type of Id�ntifi;ation j;I l I S 039
Produced ��(`��isf_ L�C•Qy�c� Produced L;!�'(`UUQk_ (_,,,Ge)A�
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( ignatu a otary Public- tate of Flor' j�PO�' �� natu tan Publi tate of Florid G
Commission No — 72 :*�°JBSr,,• ,�c� tM1gS10 r i2 Z to mission No.
,Y, SXp1R�S p�btua`1 1, ' I � '•�
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION,' SEAiTURTLE. MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED ,I '
DATE
COMPLETED
Rev.8/2/17
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