HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST 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 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
PROPOSED IMPROVEMENT LOCATION:
Address: 8632 Florence Drive Port St Lucie FL
Legal Description: I a Riinna \/it2 (-.nnnor;;tivo I Init/I of Q1(QR 1398-1724)
Property Tax ID 4: 3426-664-0090-000-4 Lot No. 91
Site Plan Name:
Block No.
Project Name: Helen Kirchner
Setbacks Front Back: Right Side: Left Side:
I DETAILED DESCRIPTION OF WORK: _ I
REROOF ��Cr.� � QdC �1 f �� '�iJ C�rI�( ,� �T
CONSTRUCTION INFORMATION: _
Additional work to bn
forme under this permit— cmc < a that apply:
HVAC Gas Tank nGas Piping IL_1' Shutters Windows/Doors
Electric ❑ Plumb' Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Constructio : S . Ft. of First Floor:
Cost of Construction: $ �2 Utilities: L_ISewer 0Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Helen Kirchner
Name: Brent Martin
_
Address: 8632 Florence Drive
City: Port St. Lucie _ State: FL
Zip Code: Fax:
Phone No. 772-342-7092
Company: ONE CALL PROPERTY SERVICES
Address: 7804 SW ELLIPSE WAY
City: Stuart State: FL
Zip Code: 34997 Fax: 772-409-8620
Phone No. 772-223-8400
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: Michael@OneCallFlorida.com
State or County License. CCL 1327836
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:__
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address: 7804 SW ELLIPSE 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 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 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 your Notice of Commencement.
Rev. 8/2/17
ignature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contra !cense Holder
STATE OF FLORIDA 1 ►
COUNTY OF wr�
STATE OF FLORI
COUNTY OF I �—
Imo` �'�
The forgoing instruWnt was acknowledged before me
The fprgoing instrum nt was acknowledged ore me
this s -day of k :,b 20 1-7 by
this day of C r 20 by
e�
4A(\
f C_� w- :,�_
-
Name of person making statement
Name of person making statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida)
( ignature of Notary Pub -St er(*uF p; daAotary Public State of Flo
� Veronica C Arteaga
Commission N ea
State of forida
Commission No. s' ' e`(M¢pmrnissionGG0572
?F�o� Expire: 12/21/2020
,1,9 Py, o Public
_° '1; Veronica C Arteaga
My Commission GG 057227
�o Expires
1212 11202 -
REVIEWS
I
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17