HomeMy WebLinkAboutBuilding Permit ApplcationDESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
Citv:
Zip: Phone: _
Not Applicable
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
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
commen.cim work or recording vow —r tice of Commencement —, /11 --.1
Signature
� "20"
see I Signature of Contractor/License Holder
STATEF FLORIDA STATE OF FLORIDA
COUNTY OF 4 L vz J COUNTY OF
The forgoing instrument was acknowledged before
me this M day of JkVA 20 1 by
� �, � g ��t. � � awl 0► v�
(Name of person acknowledging )
(Signature of Notary Nubttc- State of t-ioriaa
The oing instrument Was acknowledged before me
f
this day of J , 20_1 by
(I altd
(Name of person acknowledging )
(Signature of Notary Public- State of Florida )
Personally Known X OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Produced of Identification Produce -
°tl,,v,Puy yep
TIMOTHY R•g0'MALLEY o; p®e<e� 0 TIMOTHY R. O'MALLEY
Commission No. F �e�` t(��I�OMMISS10iJ#GG 117 3�0 'mission No. ago e;�0( PMMISSION#GG 1171
wa e EXPIRES: August 7, X021 EXPIRES: August 7, 2021
I l...dr..,..i{nre Bonded Thru Notary Pllhlin 1Ind.-
Revised 07/15/2014
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
/0b 53�-51
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 IM:PROUEMENT LOCAT'10W
Address: 12515 Orange Ave.
Legal Description: See Attached property record card
Property Tax I D #: 2308-421-0001-000-1
Site Plan Name:
Project Name: Mabry - 10633859
Setbacks Front Back:
install 26 accordion shutters
Right Side: Left Side:
Lot No.
Block No.
lditional work to be ertormed
FIHVAC
under this permit – cnecK an
❑Gas Piping
tnat apply:
❑_ Shutters
Windows/Doors
Tank0
_Gas
❑ Electric ❑ Plumbing
1:1Sprinklers
FIGenerator
❑ Roof
Total Sq. Ft of Construction:
Cost of Construction: $ 15534.00
Name George Mabry
Address: 12515 Orange Av.
SFt. of First Floor:
Utilities:.— Sewer E 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.