HomeMy WebLinkAboutgreene.pernitappALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce Ft 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 IMPROVEMENT LOCATION:
Address:
Legal De!
Property Tax ID #: 31 Q S-QQ - 01 q 1 ._QGCw I!) Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Same.., 0
CONSTRUCTION INFORMATION:
itiona wor to (_Ie De orme under this permit -check a apply:
11HVAC L Gas Tank ❑Gas Piping _ Shutters E]Windows/Doors
11 Electric Plumbing � �.i Sprinklers FIGenerator F]Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ _1 09a,QD
S Ft. of First Floor: _
Utilities: Sewer F� Septic
Building Height:
OWNERf LESSEE:
CONTRACTOR:
Name iF! " " e_
Name: M l--gri
Address: C--,m` Dr
City: Ei'-i-- R e State: fL
Zip Code:54 G14 5 Fax:
Phone No. 2'341- a23 -004?a
Company: h l
Address: 1S 3 &_FSpyfA
City: Kati- Sf Luz 4 e
Zip Code:
Phone No. -1i -
State: �t -
Fax:
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: ffid n Z4_ t IYI
State or County License:
' " `I tc I %✓1'l 6M
If value of construction is 52500 or more, a REcvKutu Notice oT Lommencement 15 requireu.
DESIGNER/ENGINEER: T Not Ap
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: � Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:_
Address:
City:_
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
commencing work or recording your Notice of Commencement., - Z/
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Signature of Owner/ Agent/ LJ see/Contractor
Signatu a of dontractor icens Molder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgoing instr e t as acknowledgeVefore me
The forgoing instr ent as acknowledge before me
this day of 2,0 by
this j day of, 2 by
(Name of person acknowledging)
(Name of person acknowledging)
X
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
Personally Known t
Personally Know OR Produced identification
-
Type of Identificati ril,'""��` 'c: MICHAEL GERHAR
Type of ident'ific tigs►Y°�.-., j � EL GERHART
:
;'; MY COMMISSION 1I FF230846
Produced -
EXPIRES May 14. 2019
Produced
- IT ISSION # FF23o846 I
.p�.
ke7. _•;d. '1t PlundaN ecv�ve
Commission No.
EXPIRES Ma
I Commission No.. v�ss
�n4itvoayse--Ke car .
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 7/2014