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HomeMy WebLinkAboutBuilding Permit Application (2) SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: x Not'Applicable MORTG NGE 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 t at 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 Comme cement 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 obtin financing,con tilt with lender or an attorney before commencing work or recording our Notice Commencement. Signatu a of;Owner/Le see/ ntractor as nt for Owner SigZTE t of Contra or/License Holder STATE OF FLORIDA S OF,FLORID COUNTY OF I •J NA e_t Q 000N OF_ c The forgoing instrument wcknowledged before me The forgo:ing instrument was acknowledged before me thisjIL-day of 20Cv/by this _4ay of 207'by Name of person making statement qame.of person making statement Personally Known ✓ OR Produced Identification Personall r Known ✓ OR Produced Identification Type of Identification Type of k entiftcation Produced Produce (Signature of Notavu - a (Signatu a of ry Public- 0 ublic- oiPavP�e( KERRY TQTH �.�g� //��a tip0.Y PV COmints3iOTrfd��� `at `,°-- No(SrQai�bnc -State of Florida ommiss oh �d�°/ 6 r'�°• ;` (S�P�aI` " RRY TQTH •- Commission#GG 041061 • - lUotar Fublic >' -State of FI ri i�OF My Comm.Expires Oct•23,202 a ; Commission#GG 041C 6 on ?TNIE .1% MY,Comm.ExDlres Oct 23 2 0 REVIEWS ,' FRONT ' ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MAN R COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17 ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO IE ACCEPTED Date: 1Permit Number: On a � 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, clic arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: iZ ZSa4W/L cevid r2 L Legal Description: Queens Cove Unit 1 Blk 1 Lot K or 4009-814 Property Tax ID#: 1414-701-0009-000-9 Lot No.K Site Plan Name: NSA Block No. 1 Project Name: Doole Setbacks Front NIA Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: Remove and replace all windows i Remove and replace rear exterior doors { I I CONSTRUCTION INFORMATION: Additional work toe e orme under tis permit-c ec -a a p y: 11HVAC Ei Gas Tank Gas Piping _S iutters a Windows/Doors Electric 0 Plumbing Sprinklers FlGenerator Roof Roof pitch Total Sq. Ft of Construction: S Ft.of first Floor: Cost of Construction:$ 7 � Utilities. —Se er Septic Building Height: OW'NERAESSEE: CONTRACTOR, Name 4A)CIrV-12 T okz, Name: - -- Address: /ZCompan : Tnt Builders of South Florida City: ©�� �l,ecr� State:Fl Address Off/ 5ri+J i�� ori ,Zip Code: 34949 Fax:NSA City: &-- Z-Otni e State:FI Phone No.772-882-1039 Zip Code: 34983 Fax: 772-344-9401 E-Mail: Phone No. 772-344-9400 Fill in fee simple Title Holder on next page(if different E-Mail: ntLbuilders@comr-ast.net from the Owner listed above) State or ounty License: CGC1517964 i If value of construction is$2500 or more,a RECORDED Notice of Commenc ment is required. I