HomeMy WebLinkAboutBUILDING PERMIT ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Will -ii-iii--milow Building Permit Application
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 x
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address: 6055 ADONIDIA PL FT.PIERCE,FL 34982 ^
Legal Description: PALM GROVE S/D BLK L LOT 6
Property Tax ID#: 3410-503-0344-000-5 Lot No.6
Site Plan Name: Block No. L —
Project Name: VAN ORDEN RESIDENCE _
Setbacks Front Back: Right Side: Left Side:
NRW
AC CHANGE OUT 3 TON, 16 SEER, 5KW
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rme unert is permit—c ec a appy:
�HVAC as Tank ❑Gas Piping _Shutters Windows/Doors
0 Electric 0 Plumbing Sprinklers Generator Roof Root pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 6100 utilities:0Sewer OSeptic Building Height: _
Name Name: STEVIE SANDERS
Address: Company: STEPHEN K DENNY
City: State:_ Address: 406 COMMERCE WAY
Zip Code: Fax: City: JUPITER State:FL
Phone No. Zip Code: 33458 Fax:
F-Mail: Phone No. 561-743-9554
Fill in fee simple Title Holder on next page(if different E-Mail: LSLATER@STEPHENKDENNY.COM
from the Owner listed above) State or County License: CAC1813800
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: X_Not Applicable MORTGAGE COMPANY: _-A Not Applicable
Name: Name: STEVIESANDERS
Add ress:6055 ADONIDIA PL FT.PIERCE,FL 34982 Address: _
City: State: City: JUPITER State: _
Zip: Phone Zip: Phone: _
FEE SIMPLE TITLE HOLDER: X_Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:406 COMMERCE WAY 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 nosted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender"oaattorney before
commencing work or recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor License Holder
STATE OF FLORIDA STATE OF FLO A
COUNTY OF COUNTY OF k Ary'1 CkP
The forgoing instrument was acknowledged before me The foing instr nt was acknowledged before me
this day of 20_ by this May ay of 20 06 by
Name of person making statement Name of persop making stat ent
Personally Known OR Produced Identification Personally Known OR Produced Identification _
Type of Identification Type of identification
Produced Produced
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(Signature of Notary Public-State of Florida) (Signature of Notary ic-Stat�bf F� Y 21,?p°•N a
Commission No, (Seal) Commission No. — (Seal)
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SE/��� Pv albs ( \`OVE
ER REVIEW REVIEW REVIEW REVIEW RE .. 1NL IEW
COUNT
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17