HomeMy WebLinkAboutBuildling Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: —ca. tel, Permit Number:C ` O3'-101(0/4
geCEIVEO
Cc uNTY
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Building Permit Application MI`
Planning and Development Services Ferm►ttin9 Counr!ent
St,tAle
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
Address: 8833 FIRST TEE ROAD PORT ST LUCIE FL 34986
Legal Description: POD 33 AT THE RESERVE PHASE 1 KINGSMILL LOT 39 ( OR 4110-24)
Property Tax ID#: 3334-500-0050-000-5 Lot No. 39
Site Plan Name: MULLEN Block No.
Project Name: MULLEN
Setbacks Front Back: Right Side: Left Side:
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Install power to two motorized shutters controlled by remote. Shutters by
Folding Shutters Si L `�p�- ULM (o
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HVAC Gas Tank EGas Piping —Shutters [ l Windows/Doors
I]Electric El Plumbing Sprinklers CI Generator a Roof
Total Sq.Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 1100 Utilities:Sewer CISeptic Building Height:
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Name Susan A Mullen Name: JAMES K WILLIAMS
Address: 8833 FIRST TEE ROAD Company: ARLINGTON ELECTRIC
City: PORT ST LUCIE State:FL Address: 3251 SE DIXIE HWY
Zip Code:3 4 986 Fax: City: STUART State: FL
Phone No. 917-797-3304 Zip Code: 34997 Fax: 772-287-2380
E-Mail: Phone No.772-287-1353
Fill in fee simple Title Holder on next page(if different E-Mail:gregg@arlingtonelectricinc.com
from the Owner listed above) State or County License: EC 13007767
500 more, RECORDED Notice of Commencement Is required.
If value of construction is$2 or a RE R q
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DESIGNER/ENGINEER: ; ' 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: __Not Applicable
Name: Name:_
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
,
• .
1 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
cofore the first inspection. if you intend to obtain financing,consult with lender or an attorney before
mmencing work or recording your Notice of Commencement.
VIA._.);thz.,....
_Sig ture of Owner/Lessee/Agent Sig ure of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF MARTIN
The forgoing instr^um-�nt was acknowledged before me The forgoing instrument was acknowledged before me
this day of Vv l IN.v cam.. , 20 I'iby this) day of VA H t G L- ,20 19 by
/ t \1
AVAR e,S IV\ l • b\t P V JAMES K WILLIAMS
(Name of person acknowledging) (Name of person acknowledging)
, qk CU)-,--
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(Signature o ary Public-State of Florida) (Signatures otary Public-State of Florida)
Personally KnownOR Produced Identification Personally Known T OR Produced Identification •
Type of Identificatio'h Produced Type of Identification Produced
• CommissioWb.---- — ` — — —+' Commission
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' `otvn(;, tiHt.GG H RO INS N ' , °�a GHEGG HAWN-904k N
lop`Ia�, Nofary Public State of Floriaa i° ``�= Notary Public-:State o1 Florida
( `=,• a Commission#Gt,063149
Commission#GG 033149
1 1 't, "' o;= MyComm.Expires Sep 25,2020
Revised' +' ,—e- My Comm.Expires Sep 25,2020 �;,� �,. `
Bonded through National Notary Assn. ` 4 %R°U *" Bonded through NatiOnal Notary Assn.
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