HomeMy WebLinkAboutBuilding Permit Application (2) SUPPLEMENTAL CONSTRfUCTIbNNN'LAW INFORMATItSx M
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DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address:2 Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:2440S JENKINS RD 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 empt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools, nces,walls,)aotice
screen rooms and accessory uses to another non-r ntial use
WARNING TO OWNER:Yo rr f lure to Recorof Commencement may result in you paying twI for
improvements to your pro a y.A Notice omencement must be recorded and po ted on the jo site
before the first inspe ion. you intend to financing, consult with lender or an orney beforecommencin k or cor in our Noticmmencement.
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Signature of Owner/Les a Cont ctor as Agent for O Signatur Contractor ense}10 er • ,Y;,'*„••°
STATE OF FLORISTATE OF FLORI m�
COUNTY OF . COUNTY OF a”"
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The f44{{ ing instr ent as acknowledge efore m 2 he f oing instr ent as acknowledge fore me g
thiso( day of 20�by �< hi�L day of 21 by
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GSC u
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Name of pers making statement m C5 Name of person making statement "a
Personally Known OR Produced Identification -. i�zj ersonally Known�`OR Produced Identification
Type of Identification ype of Identification
Produced rod uced
O44ix�;a
Pubilic-
(Signature of ary State of Florida) (Signature of N Public-State of Florida)
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application SEP 2 4 2018
Planning and Development Services
Building and Code Regulation Division Peirmitting Depart-nnent
2300 Virginia Avenue,Fort Pierce FL 34982 LL, e County,, FL
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Re-si, I tia,6L.
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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PROPOSED 11�AP'kbV'
,EM LOCATION
Address: R 0�0*'_Dl
Legal Description: INDIAN RIVER STATES UNIT 07
Property Tax ID#: 3402-608-0475-000-9 Lot No.35
Site Plan Name: Block No. 52
Project Name:
Setbacks Front Back: Right Side: Left Side:
,
DETAILED DESCRIPTION OF-WO
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Z
REPLACE ALL WINDOWS ONE SLIDING GLASSrTH IMPACT RATED AND REPLACE ONE EXTERIOR DOOR.
tdNSTRUC7
ON
INFORMATION
Additional work to be nerformed under this permit—check all apply:
0HVAC Gas Tank E]Gas Piping _ Windows/Doors
11 Electric Plumbing OSprinklers E]Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt of First Floor:
Cost of Construction:$ Utilities: ]Sewer[]Septic Building Height:
QW N E R/ :,CONTRACTOR
Name )—r%Q-V U 13 VJ� Name: —F&P--%\,3 LPb C.) U e t_-,&C.0
Address:520 Company: ADVANCE BUILDING CONTRACTORS INC
City: -e\-CP 4e State:FL Address: 2440S JENKINS RD
Zip Code: 3498Fax: City.rV--sT"\ erC a State:FL
Phone No.203-560-5553 Zip Code: 34947 Fax:
E-Mail:— Phone No. 772-342-6928
Fill in fee simple Title Holder on next page(if different E-Mail: advancebuildingcontractors@gmaii.com
from the Owner listed above) State or County License: CRC 1331595
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.