HomeMy WebLinkAboutBuilding Permit Application (2),SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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DESIGNER/ENGINEER: Not Applicable Pp
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
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 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 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 recording your Notice of Commencement.
c—�
Signature of Owner/ Age/ Le
STATE OF FLORIDA
COUNTY OF St Lucie
The forgoing instrument was acknowledged before
me this day of , 20 18 by
Arthur Wayne Francis
(N o rson ack dging )
(Signature of Notary Public- State of Florida )
Personally Known X OR Produced Identification
Type of Identification Produced
Commission No.
Revised 07/15/2014
Signature of Contractor/Lice se r
.. a I I 1 M,
•
The forgoing instrument was acknowledged before me
this day of , 2018 by
Arthur Wayne Francis
(Na son ackno g )
(Signature of Notary Public- State of Florida )
Personally Known X OR Produced Identification
Type of Identification Produced
Michie Rob&tsCommission No.
NOTARYI�
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
Date:
Permit Number:
Planning and Development Services
Building and Code Regulation Division
2sooVirginia Avenue, Fort Pierce r/s4s8z
Phone: (772)462 1553 Fax: (77I)462 1578 Commercial Residential X
PERMIT APPLICATION FOR: Window/door
PROPOSED IMPROVEMENT LOCATION:
Address: GO4OVVhipoonwULn. Port Saint Lucie, FL, 34Q87
Legal Description: HIDDEN ACRES BLK C LOT 2 (2.89 AC)
Property Tax |D#: 3211-811-0017-000'9
Site Plan Name:
Project Name: 10855252 Southwick
Setbacks FrontBack: Right Side: Left S|de:________
DETAILED DESCRIPTION OF WORK:
Replace 14 windows size for size (NOA# 17-0014.09. 17-0830.08)
Lot No.—
Block No.
o._B|ockNo.
iaitionaiwori(TODeperrormea unuerzn/s n necxao inat oppiy:
HVAC Gas Tank[]GasPipinQ �=�Shutters Windows/Doors
[]SprinklersL�]Electric �=�Plumbing L`~�—� �Generator E]Roof
Total Sq. PtofConstruction: __
Cost of Construction: S 20,881Utilities:cn Sewer 0Septic
of First |
Building Height:
OWN ERAESSEE:
Name Nelson Southwick
Name: Arthur Wayne Francis
Address:. 6040 Whipoorwill Ln.
Company: The Home Depot
City: Port Saint Lucie State: FL
Zip Code: 34987 Fax:
Phone No. 772-216-0597
Address: 6500 NW 12TH Ave. Suite 110
City: Fort Lauderdale State: FL
Zip Code: 33309 Fax:
Fill in fee simple Title Holder on next page if different
from the Owner listed above)
E -Mail: jordan.dedios@expeditepermit.com
State or County License: CGC061641
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.