HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ''11
Date: Permit Number: U ' ® 0
RECEIVED
J
Building Permit Application FEB 0 72018
Planning and Development Services ST, Ly1ucie cv�,nty permitting
Building and Code Regulation Division FEB 2018
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential Yes
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 6580 Dulce Real Ave Fort Pierce FI
Legal Description: SPANISH LAKES FAIRWAYS 6580 Dulce Real Ave Fort Pierce FI
Property Tax ID#: 1306-111-0001-000-0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: Q �
Reroof Remove Shingles NEc✓ -5h,N y/r4s c,v c""w )V6
/300
CONSTRUCTION INFORMATION:
Additional work toe er orme under this permit—check a appy:
HVAC 11 Gas Tank []Gas Piping _Shutters Q Windows/Doors
11 Electric ❑Plumbing Sprinklers Generator FV] Roof Roof pitch
Total Sq. Ft of Construction: 1800 Sq. Ft.of First Floor: 1600
Cost of Construction:$ 7 250 Utilities:0 Sewer-Septic Building Height: 14 Ft
OWNER/LESSEE: CONTRACTOR:
Name nepper Ulittord Name: John Durham
Address:6580 Dulce Real Company: Durham Brothers Inc
City: FortPierce State:_ Address: 1 n
Zip Code: Fax: City:I
Loxa a c ee State: Fl
Phone No. d Zip Code: 33470 Fax: 94.354T
E-Mail: Phone No.
561.315.1
Fill in fee simple Title Holder on next page if different E-Mail: John uC am msn.com
from the Owner listed above) State or County License: tate
GGG 1326757
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.
Sign ure of Owner/Lessee/Contractor as Agent for Owner Sign a of Contractor/License Ho116r
STATE OF FLORIDAI SATE OF FLORIDA
COUNTY OF c�C �� c(^ COUNTY OF na
The for oing instrument was acknowledged before me The forg oing instr ent was acknowledged before me
this day of 20(_& by this S day of - 20 l$ by
Name of person making statement Name of person making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identificatio Type of Identification
Produced FI- t'50 (QK 5:7-70-0 Produced
G
(Signat of Notar ubl' State of Florida) (Signature Notary Pu -S e of Florida )
Commission No. EVENTRY,JR. Commission No.
,: MY COMMISSION#GG 136314 r i%, KYLE LEE VENTRY'13
"�' MY COMMISSION#C+O 136314
"• _o: EXPIRES:August 20,2021 21
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REVIEWS FRO ISOR PLANS VEGETA ..0m
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17