HomeMy WebLinkAboutBuilding Permit ApplicationFEB -15-2018 THU 09 29 AM CENTRAL SCHEDULING FAX No. 3212686138 P-002
ALL APPLICABLE I F MOST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:„ �) Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce i:L 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
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Address: CAWA-Tief(f fl
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Legal Description,kJ
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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Add0ionai work o be pertormed underthis permit— checK a I t= appy:
HVAC Gas Tank Das Piping Shutters Q Windows/Doors
_
OElectric Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S . Ft. of First Floor:
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Cost of Construction: $ �Vl oQ utilities:tSewer 0Septic Building Height:
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Name
Name: mad
Company:&19'
I
Address:
City:kiA , CL7- State:
Addr
Zip Code: Fax:
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City: %n�t (�~
Phone No.
fState:
Zip Code: goFax: J)J —
E -Mail:
Phone No.
E -Mail ( q I
Fill in fee simple Title Holder on next page (if different
from the owner listed above)
State or County License: ' i WWF
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
FEB -15-2018 THU 09 30 AM CENTRAL SCHEDULING FAX No. 3212686138 P•003
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 make$6 no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict wlth 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 5t, 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
rnmmencing work or recardine vour Notice of Commencement.
Signature 0 ner/ Lessee/Contractor as Agent for Owner
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ar .� X1• ,?a• �.. .a: a x.. •.. * y �t�'It. i
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The for Ding instr ent was acknowledge before me
this , day of C�0 201B by
`.',�"?
DESIGNER/ENGINEER:
Not Applicable
Personally Known OR Produced Identification
MORTGAGE COMPANY:
Not Applicable
Name:
Produced
Produced
Name:
Address:
A. Catherine Konger
Address:
City:
State:
City: State:
Zip: Phone
"' � �• 1bSFB014DED 0TARRx1LC
. OFfV;••' BONDED THRU
'�auU•` IST FLORIDA NOTAR-411;
Zip: Phone:
FRONT
FEE SIMPLE TITLE HOLDER:
Not Applicable
PLANS
BONDING COMPANY:
lNot Applicable
Name:
COUNTER
Name:
REVIEW
Address;
REVIEW
REVIEW
Address:
DATE
City:
City:
Zip: Phone:
RECEIVED
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 make$6 no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict wlth 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 5t, 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
rnmmencing work or recardine vour Notice of Commencement.
Signature 0 ner/ Lessee/Contractor as Agent for Owner
Signatur of ontractor/License Holder
STATE ORIDA 1
COUNTY OF - \
STATE O FLORIDA f '
COUNTY OF 11f�Ci
The fo�oing lnstr, e, ttr% s acknowledgedbefore me
this yy day of�1Q zp by
The for Ding instr ent was acknowledge before me
this , day of C�0 201B by
Name of persTp making statement
Name of per on making statement
Personally Known OR Produced Identification
Personally Known OR Produced identification
Type of Identification
Type of identification
Produced
Produced
(Signature of NotaryPublic- Flor
'� &rine Konger
(Signature of Notary Public- Stat Florida )
A. Catherine Konger
Commission N �onFF172372
'� =S*OCT 28,
i C 72
Commission No. 1 [onFF1723
2018
_
* ••� Expires: OCT 28, 2018
"' � �• 1bSFB014DED 0TARRx1LC
. OFfV;••' BONDED THRU
'�auU•` IST FLORIDA NOTAR-411;
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17