HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1
Date: 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 x
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Address: 121 QUEEN EUGENIA CT. N HUTCHINSON IS FLORIDA 34949-8318
Legal Description: LOT J BLOCK 6 QUEENS COVE UNIT 1 ACCORDING TO THE PLAT AS RECORDED IN PLAT BOOK
11 PAGE 12A THROUGH 12 C OF THE PUBLIC RECORDS OF ST LUCIE COUNTY FLORIDA.
Property Tax ID#: 1414-701-0052-000/5 Lot No.
Site Plan Name: QUEENS COVE Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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INSTALL 4, SETS OF NAUTILUS ROLLING SHUTTERS. (See Installation Detail Sheet for Particulars)
Additional work toe performed under this permit—check a appy:
11HVAC 11 Gas Tank []Gas Piping _Shutters Q Windows/Doors
❑Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ Utilities: Sewer OSeptic Building Height:
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Name THOMAS FITZGERALD Name:
Address: 121 QUEEN EUGENIA CT Company:
City: N HUTCHINSON IS State:FL Address:
Zip Code: 34949-8318 Fax: City: State:
Phone No.954 531 9918 Zip Code: Fax:
E-Mail:9986640@GMAIL.COM Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: 4 Not Applicable
Name: Name:
Address: 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 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
commencin g work or recording our Notice of Commencement.
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Signature of Owner/Oessbe/Contracto as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA I STATE OF FLORIDA
COUNTY OF S ).R�s_Jq_ COUNTY OF
The forgoing instrum nt was acknowledgeA before me The forgoing instrument was acknowledged before me
this day of 20-11- by this day of 20_ by
Name of person makingUlaernient Name of person making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Prodaed Produced
(S'
atA of Notary Public-State f Florida) (Signature of Notary Public-State of Florida)
Commission No. •p1Q••, SEfAF1iVAtl� Commission No. (Seal)
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REVIEWSSL••,• R PLANS VEGETATION SEA TURTLE MANGROVE
OF C Nfi RG -) 1PON41 VIEW REVIEW REVIEW REVIEW REVIEW
DATE B i E B •;f3 1
RECEIVED 2 00005(1;990392
DATE
COMPLETED
Rev.8/2/17