HomeMy WebLinkAboutBuilding Permit applicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
5` JM
• . all
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
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 8591 Hidden Pines Rd.
Legal Description: Hidden Pines Estates Bilk B Lot 4(1.00 AC)
Property Tax ID ii: 2323-701-0019-000-6
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side
replace 2 doors size for size (NOA 17-0420.06)
aanionai worK to De errormea unaertms permit —ci
❑HVAC Gas Tank ❑Gas Piping
11 Electric ❑ Plumbing ❑Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 19820.00
Left Side:
II Shutters
❑ Generator
SFt. of First Floor: _
Utilities:"n Sewer ❑ Septic
Lot No.4
Block No. B
Windows/Doors
❑ Roof
Building Height:
OWNER/LESSEE:
CONTRACTOR: i
Name Deflev Tiszauer
Name: Arthur Wayne Francis
Address: 8591 Hidden Pines Rd.
Company: The Home Depot
City: Fort Pierce State: FL
Zip Code: 34945 Fax:
Phone No.
Address: 6500 NW 12TH Ave. Suite 110
City: Fort Lauderdale State: FL
Zip Code: 33309 Fax:
Phone No. (754) 224 - 2010
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: jonathon.thomas@expeditepermit.com
State or County License: CGC061641
If value of construction is $2500 or more, a RECORDED Notice of commencement is requwrea.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
FRONT
DESIGNER/ENGINEER:
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
MANGROVE
Address:
COUNTER
City:
Zip: Phone:
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Countv 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
O
Signature of Owner A ent/ Lgr4e Signature of Contrac r nse Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Stlude
The forgoin as c
instrument knowledged before
me this a4 day of 20 18 by
Arthur Wayne Francis
4(Na,meerson acknowledgin ary Public- State of Florida )
COUNTY OF si wde
The fq�gping instru t as acknowledged before me
`(
this day of 2018 by
ry Public- State of Florida )
Personally Known x OR Produced Identification I Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
pqy Jonathon Thomas �IpAY4 Jonathon Thomas
Commission No.°� 4 ADTARY PUBLIC Commission No. o NOi')PUBLIC
STATE OF FLORIDA ?� STATE OF FLORIDA
Revised 07/15/2014
Expires 9/18/2021
Expires 9/18/2021
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
(e"tt-141