HomeMy WebLinkAboutBuilding permit applicationALL 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 f
2300 Virginia Avenue, Fort Pierce FL 34982 <��(
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from drophox, click arrow at the end of line
PROPOSED IMPROVEMENT. LOCATION,
Address: 11 00 1. _5� i1i � jW R
Legal Description:
Property Tax ID #: 35li ' �% Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
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Es o o,-r1t,J G M E Tek e P�tj'
CONSTRUCTION .INFORMATION:
Additional wor to e e ormed under this permit— check all apply:
❑HVAC Gas Tank ❑Gas Piping _ Shutters Windows/Doors
Electric Plumbing Sprinklers ElGenerator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
(�
Cost of Construction: $ I Cr) ck! W Utilities: 0_ Sewer ❑ Septic
OWNER/LESSEE: CONTRACTOR:
Name 1 11Ut -1.1,'�>
Address: I17 G.Lot JS Kb
City: Pr P1 gRCF_ State: L
Zip Code: 3`f1 _1 Fax:
Phone No. 77J_—
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Building Height:
Name: ARTHUR ENGELMANN
(7mmnanv: ACCURATE ELECTRICAL CONTRACTING, INC
Address: 7193 GULLOTTI PLACE
City: PORT ST. LUCIE State: FL
Zip Code: 34952 Fax:
Phnna No- 772-878-9171
E-Mail: ACCURATEELECTRICPSL@OUTLOOK.COM
State or County License: ECO003072
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name: ARTHUR ENGELMANN
Address: Address:
City: State: City: PORT ST_ LUCIE State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address: 7193 GULLOTTI PLACE
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
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 fyii�t inspectio you intend to obtain financing, consult ith lender ory attorney before
commen66_4 work of r rding your Notice of Commencement.
Signature of Own r/ Lessee/Contractor as Agent for Owner
STATE OF F RIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this Xr day of SyV VC 20-a by
Name of person
Personally Known /'\—
Type of Identification
Produced
I
(Signature of Notary Public- State
Commission No,
(Seal)
REVIEWS FRONT I ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
Signature of Contrgtor/License Holder
STATE OF FLOIDA��
COUNTY OF
The forcing instrument was acknowledged before me
this 17 d®of ,SUN 20�by
elay
Name of person making
Personally Known z_ OR Pi
Type of Identification
of Notary Public- State of
Commission No.
W.
ri
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SUPERVISOR I PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW