HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLI ABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: A 1 1 zO l ci� Permit Number:
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
Address: Sao q 'S ( ( Vim' ri�,-,v_ -P (-
Legal Description:17r,d,tarx P -,.,V" arkt`" 0!� -e>iy- a5 lot lir /S
Property Tax ID #: 3q o,;� ted -- (o Lot No. (S
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Block No. co; .s
CONSTRUCTION INFORMATION:
CONTRACTOR -
Name DW16 L'.
Name: GLV t v -
Additional work to be nertormed under this permit- check
HVAC Gas Tank Gas Piping
all
JhaJ appy:
Shutters
Windows/Doors
Zip Coder Lf 9Fax:
City:f)01r-1-- tIStater
Phone No.77d-T71-__3(o1
Zip Code: 2!Wi� 31 Fax:
t�
11 Electric 101 Plumbing
O Sprinklers
from the Owner listed above)
1:1 Generator
Roof Roof pitch
Total Sq. Ft of Construction:
Sq.
Ft. of First Floor:
0 I]
Cost of Construction: $
Utilities:
Sewer Septic
Building Height:
C?W ER/LESSEE:
CONTRACTOR -
Name DW16 L'.
Name: GLV t v -
Address: 5�ky4 5, 1y'eroctk. Dr
Company: T d
City: E I }moi State: (r
Address: i <,--,E Soull N)iefm eq e4 -__0.t i
Zip Coder Lf 9Fax:
City:f)01r-1-- tIStater
Phone No.77d-T71-__3(o1
Zip Code: 2!Wi� 31 Fax:
E -Mail:
Phone No.
E -Mail: Ni . 6 rn
Fill in fee simple Title Halder on next page (if different
from the Owner listed above)
State or County License: C'F-I L4
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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
pplyen 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-. 1% Z
Signature of Owner/ Agent/ L see/Contractor
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name:
Name:
Address:
City:
_
State:
Address:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: i Not Applicable
BONDING COMPANY:
Not Applicable
Name:
Name:
Address:
(Signature of Notary Public- State of Florida }
Address:
City:
City:
Personally Known eFc4eedd�€�
Zip: Phone:
Zip: Phone:
Type of identific tlgw -�--
-=� `< MICHAEL �ER�JIRT
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
pplyen 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-. 1% Z
Kev. ///-UI.+
Signature of Owner/ Agent/ L see/Contractor
Sigr(atu e of contractor kens older
S'T'ATE OF FLORIDA
COUNTY OF
STATE OF FLORI
(& -e,
COUNTYOF
The rgoing instrument was acknowledged before me
thisl day of �,(A 201qby
The fp1going instrument was acknowledged before me
this day of by
(Name of person acknowledge g )
(Name of person acknowledging)
y.
(Signature of Notary Public- State of Florida }
(Signature of Notary Public- State of Florida )
Personally Known eFc4eedd�€�
Personally Know OR Produced Identification
Type of Identificati '°R''° ic; MICHAEL GERHAR
';
Type of identific tlgw -�--
-=� `< MICHAEL �ER�JIRT
Produced MY COMMISSION u FF230848
Produced
.9 .
•?<IF".•• EXPIRES May t4. 2019
,•:G%. sv.- v ,:.l rk,�«.�aN <x
- 41SSION # FF230846
'•. EXPIRES
%Ommission-No. :?a, MaA-%*Z.g
Commission No. au*
iurn�atyoaySr=vxr cin-
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev. ///-UI.+