HomeMy WebLinkAboutBuilding Permit applicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
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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: -731 671 L6S P>LV b
Legal Description.
Property Tax ID #: 4,50J, 50 a — 09 17 " 0OC3— P Lot No. 7311
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Block No.
DETAILED DESCRIPTION'{]EWORK:
,VlcE (fN GE- REMOVE A b REPS, IZ,+iL49 fialS L. dWPIM'
CONSTRUCTION INFORMATION:
Additional work toe oertormed under this permit— check all that appy:
QHVAC EhasTank Gas Piping _ Shutters ❑ Windows/Doors
Electric Q Plumbing ❑ Sprinklers ❑ Generator L=1 Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ _500 cc
Sq. Ft. of First Floor: _
Utilities: 0 Sewer ❑ Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR
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Name M 110 S (v 3 LLC
Name: ARTHUR ENGELMANN
Address: 7715 mum_ W Y
Company: ACCURATE ELECTRICAL CONTRACTING, INC
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City: l UES7EP`�lJl-+� b , Odr State: QTf
Zip Code: qq0b_Vb— 13-37 Fax:
Phone No. 772- 90�q — qq
Address: 7193 GULLOTfI PLACE
City: PORT ST. LUCIE State: EL
Zip Code: 34952 Fax:
Phone No. 772-878-9171
E -Mail:
Fill in flee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: ACCURATEELECTRICPSL@OUTLOOK.COM
State or County License: ECO003072
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION;
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name: ARTHUR ENGELMANN
Address:
Address:
City: State:
Zip: Phone
City, PORT ST. LUCIE State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: ^ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address: 7193 GULLOTTI PLACE
Address:
City:
Zip: Phone:
City:
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
commeni;�Vg work or.,roording your Notice of Commencement.
Signature of Ther/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was
acknowledged before me
this day of
20?_�7by
Name of person m
ing statement
Personally Known �,rOR
Produced Identification
Type of Identification
COMPLETED
Produced
(Signature of Notary Public- mate of F0011111141111,
O�IS C.
Commission No. �\ Q.• li
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REVIEWS
FRONT-"'
COUNTERDATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
Signature of Cont ctor/License Holder
STATE OF FLORIDA
COUNTY OF
The for5oing instrument s nowledged before me
this day of 0_6;;�"by,
Name of person making staWment
Personally Known � v Produced Identification
Type of Identification
Produced
r
(Signature of !Votary Public- State of F foricla j,,,,,,••
Commission No.��'���'�.',P�R��i,
1
R PLANS I VEGETATION I SES
REVIEW REVIEW R
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