HomeMy WebLinkAboutBuilding Permit Applicaiton ;"FALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/11/2018 Permit Number: Vi-t,\1?---. 0/A4 1
b.,TCL a Com. r
COUNTY
FLORIDA
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, click here 11
PROPOSED IMPROVEMENT LOCATION: -
Address: 1207 DRIFTEWOOD LANE 1
I
Legal Description: .
Property Tax ID#: 3404-808-0016-000-4Lot No.
MIKE NELSON ,�
Site Plan Name: Block No.
Project Name: MIKE NELSON I
Setbacks Front Back: Right Side: Left Side: I
DETAILED DESCRIPTION OF WORK:
POOL HEAT PUMP Rk p)OL OA raky
E l e c
CONSTRUCTION INFORMATION:
Additional work to be ertormed under this permit—check all pai apply:
ElHVAC Gas Tank Gas Piping Shutters El Windows Doors 1
LElectric 0 Plumbing El Sprinklers ❑Generator ❑Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 2400.00 Utilities:LJ Sewer El Septic Building Height:
OWN ER/LESSEE: CONTRACTOR:
Name MICHAEL NELSON Name: ROBERT TRYON
Address:1207 DRIFTWOOD LANE Company: TRYON PLUMBING INC
City: FT PIERCE State:FL Address: 925 WAGNER PLACE
Zip Code: 34982 Fax: City: FT PIERCE State:FL
Phone No.772-216-2053 Zip Code: 34982 Fax:
E-Mail: _ Phone No. 772-465-0284
Fill in fee simple Title Holder on next page(if different E-Mail: TRYONIO@AOL.COM
from the Owner listed above) State or County License: CFC058068
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
1
•
SUPPLEMENTAL CONSTRUCTION MN LAW INFORMATION.
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: 0 . Name:
Address: _ tl tilla ! i� .I, I_► ! t address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address:925 WAGNER PLACE 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 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 fora
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.
Signature of Owner/Lessee/Contractor nt for Owner Signature of Contractor/License Holder
STATE OF TATE OF FLORIDA
COUNTY OF FLORIDA,i _ LuC.(e COUNTY OF S�'. �,l,LCife
The forgoing instrument was acknowledg d efore me The forgoing instrument was acknowledge efore me
this 11 day of DECEMBER ,20 1Y by this 11 day of DECMEBER ,20 I by
Name of person making statement Name of person making statement
Personally Known X OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Type of Identification
Produced Produced
r► v�0 , to i 1/ I �Q. rn yjv
(Signature oVNotary Publi •* • o-� (Signature of N ary Public-Sta a of FI da)
,0;g1'p,&,, KARLEY MARIE GIESY-VARNEY I ( �'P•, KARLE ARI IESY•VARNEY
Commission No. "�
( ,IDublic-State of I Commission No. o �'�;
NotaryINNIttate of Florida 0
• Commission:GG 099801 • ,,
=, 111: r/ My Comm.Expires May 1,2021 ��` P Commission.Expires r G0y 1,2021 b
,,,°F� Bonded through National Notary Assn. ' % Fo My *m; May�
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17