HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6/19/2018 Permit Number: ( 76 (0 - 052,q
_ _.: RECEIVED
Building Permit Application JUN 2 0 2018
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
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: 6105 Palm Drive Ft. Pierce FL 34982
Legal Description:
Property Tax ID#: 'Sy O Z" o ��� Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
HVAC Change Out .'r To 11 r /lo So-e-f-� 7 "!70
�6NTRUCTILON INFORMATION:
Additional work toe e orme under tispermit—c ec •a appy:
HVAC 11 Gas Tank ❑Gas Piping Ll Shutters Windows/Doors
11 Electric 0 Plumbing Sprinklers 1:1 Generator Roof Roof pitch
Total Sq. Ft of Construction: 3256 Sq. Ft.of First Floor: 1134 under air
Cost of Construction:$ 3900.00 Utilities:Sewer E]Septic Building Height:
OWNER/LESSEE: r CONTRACTOR:
Name Kay Robinson Name: Steven Schroeder
Address:6105 Palm Drive Company: Air By Steve
City. Ft. Pierce State:FL Address: 153 SW South Danville Circle
Zip Code: 34982 Fax: City: Port St. Lucie State:FL
Phone No.772-519-3992 Zip Code: 34953 Fax:
E-Mail:N/A Phone No. 772-249-6812
Fill in fee simple Title Holder on next page(if different E-Mail: airbysteve@gmail.com
from the Owner listed above) State or County License: Cac1819127
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 recordingyour Nopicelof Commencement.
Z64 -1 -
Signature of Owner/Lessee/Contractor as Agent for owner Signature of Contractor/License Holder
1
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
Thefor oing instr ment was acknowledge efore me The fo going instr ment was acknowledged efore me
this day of 20by this ay of 20_a by
N �O' I✓o e,V- evnvi
Name of person making statement / Name of person making statement /
Personally Known OR Produced Identification ✓ Personally Known OR Produced Identification f/
Type of Identifigation Type of Identific ion
Produced L" b� Produced ( L_
C CL
(Signat a of Notary Public-State of Florida) (Signature of NotaryRk' + t,� e o �N)S. NIELSEN
;State of Florida Notary Public
Commission No. EN S. NIELSE mission No. Commis[���$p�rId� GG 207484
c 4, brr�o�`. My Commisgion Expires
;_� ��;State of Florida-Notary PILii,: �n„+n�` June 12, 2022
Commission #GG 20744
+nm�` June 12, 7.022
REVIEWS FRONT NS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17