HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
J -
•
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 I1IJIPROVEMENT LOCATION.
Address: 11 1 7 S, -SOL4z Ai 6
Legal Description:
Property Tax ID #: Lot No.
Site Plan Name:
Project Name:
Setbacks Front Back
Right Side: Left Side:
Block No.
DETAILEDDESCRIPTION OF WORK:.
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CONSTRUCTION INFORMATION:
Additional work to flGasTank
orme un er t is permit— c ec a appy:
HVAC Gas Piping Shutters Windows/Doors
ZElectric 1:1 Plumbing E]5prinklers Generator Roof Roof pitch
Total Sq. Ft of Construction:
op
Cost of Construction: $ /,00 �
SQ.Ft-of First
j Floor:
Utilities: L 1 Sewer L_=1 Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
n
Name I-fA b1 11. S0 )
Addresa, /g / 7 s e: bel,,IAicv-F—
Name: ARTHUR ENGELMANN
Company: ACCURATE ELECTRICAL CONTRACTING, ING
City: Pb2 Sr L)O iE State: FL
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Zip Code: q 1.'! Fax:
Phone No. 7 % — 'v' 70-- 05g6
Address: 7193 GULLOTTI PLACE
City: PORT ST. LUCIE State: EL
Zip Code: 34952 Fax:
Phone No. 772-878-9179
E -Mail: 166 i V7(&_ BE:,Qui 4 •+'J0_
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: ACCURATEELECTRICPSLa@OUTLOOK.COM
State or County License: ECOOD3072
i
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name: ARTHUR ENGELMANN
Address: Address:
City: State: City: PORT 5T. LUCIE State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:7193 GULLOTTI 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.Luc
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 f t inspection. If you intend to obtain financing, consult vith lender or an attorney before
commenciVjiwork or r9fording your Notice of Commencement.
of Own
as Agent for Owner I Signaf6re of Cont�#ctor/License Halder
STATE OF FLOdiDA %/�I
STATE OF FL
COUNTY OF ,�f �� COUNTY OF.
The forgoing instrument was acknowledged before me
this day of Zb� by
Name of per:
Personally Known
Type of identification
Produced
1
k
#GG 137147
(Signature of Notary Public- State
Commission No. (Seal)
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
DATE
COMPLETED
Rev. 8/Z/17
The forgoing instrument was acknowledged before me
this day of 2p� by
Name of persorfmaki
Personally Known /�R
Type of Identification
Produced
11-N . ,
at�e�•�15510H�;fCi
ILed Id4,'�
4
tiGG 137147
Grp'' ','� �dRded t1��'�.�' • O��
ature of Notary rfublic- State of
Commission No.
(Seal)
SUPERVISREVIEWOR I REVIEW NS I VEGETATIREVIEW�N S
REVIIATURTEW I MANGRO
REVIEWVL