HomeMy WebLinkAboutBuilding Permit Application ALL APPPLIC BL INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: -T I b Permit Number:01111
ELREED
Building Permit Application 2018Planning and DevelopmentServicesBuilding and Code Regulation Division ������,ll--------
2300 Virginia Avenue,Fort Pierce FL 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 F,
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Legal Description:
Property Tax ID#: 3 1 tea' a dd 1d O o0- (, Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK � ' �� ,x� � `� '
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CONSTRU
Additional work to 3 e nerformed un er t is permit—check a appy:
HVAC0 Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
J0Electric 0 Plumbing Sprinklers FI Generator 0 Roof Roof pitch
Total Sq.Ft of Construction: S .Ft.of First Floor:
Cost of Construction:$ Utilities:Sewer D Septic Building Height:
01NNEft/LE5S � r _ , t 4 ° CONTRACTOR '
&.a,t�,' ,„Sd .,5�
Name Qd,c �' S'� , lL�it P�gz� Name:
Address: 1\�. Q by s �'� . Compan
411
City: t\wrey. StateAVI Addr s
Zip Code: �\oa3 Fax: City: State:
Phone No. Zip Code: Fax:
E-Mail: Phone No. r ”
Fill in fee simple Title Holder on next page(if different E-Mail:�t 11
from the Owner listed above) State or County License:
If value of construction Is$2500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
N am e:DAYANNAND SUNDARSINGH
N a m e:JAMES FINDLEY
Ad d re ss:514 Tumblin Ming Rd Address: 520TUMBLIN KLING RD
City: FT PIERCE State: City: PORT STLUCIE State:
Zip: -Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:2234 SE HOLLAND STREET 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 record'ng your Notice of Commencement.
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Agnature of Owner/LeVe-e/Contra—ctor as ent for Owner S91igture&ofContractor/ icense Ho der
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STATE OF FLORIP# STATE OF FLOWVk
COUNTY OF c=1,!t Lai, COUNTY OF
The fWoing instr t wa acknowledg before me The fnoing ins tw4menta)acknowledg.,4,kefore me
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this day of �C, f
this jL-&day o .20 by
a�Rer.
Name of pers making stAeme Name of pers making stateTenj
Personally Known OR Produce clentification Personally Known OR Produced-rcrentification
Type of Identification Type of Identification
Produced Produced
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AignatLIre of Vignatde of Notary Public-State of Florida
Notary Public State of Florida
Jac ue�line A pas V?-!PU Notary
My Commission FF 899682
Expires 08/22/2019
M My Commission My ComiWission FF 899682 Jacqueline A PascarellO
Expires
08/ 01 9
m is Expires 08/22/2019
Commission
sion Jacaueline A Pas4v9) Commissi nryPublic tateofFlor(d3eal
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17