HomeMy WebLinkAboutBuilding Permit Application To: Page 3 of 4 2019-07-03 21:06:47(GMT) 17726735762 From: DAVID KRUSE
ALLAP.pLICABLE t1VFO.IIiil1S7 Bi::C>3MP1d T,ED FGR.`APPLlGATION:T013E.ACCEPIE .
..-Date;. 0576712018 Permit Nur
,
.. JU ..
�. ..� 2019 •..... : • ;
1?7annrri and Oearetoprneni Services .
2 rm i.tti Cle.p l rU' nt'
Building dnd Code Reguladdo Dr'v7sion St.' Lu c le'
County FL
23DDVirginia Avenue Fort:Pierce r"L 3�982 , r
Phone:..(772)+ 62-1553 Fax:.(7.72)-462-1578' lCoirnmercial Residential x.. :
PERMIT APPLICAnON.FOR: To select from dropbox; click arrow pt the end of ljne
C` M �+1� r.+m .v s ��, fl_ n/,^` *^,"f. t ry Via'- ."'p:f""' .s '�T•`L r
Address:.:40 Temple Avenue, Fort Pierce, FL:34982
Legal Description:.'Tangelo Viiiage(Maravilla Gardens n PAST C')
2427-661-t7v8-ODQ 2
Prop rty Tax ib ,. :. Lot No.
5..0 Plan Name:` Block No. .
7777
Project Name:
Setbacks •Frontes -Back,. Right Side: ' .Left Side:
Rpm
tlt �"1�:IwQ�1� S�G•lRRlPTf77N � [l tkr § ,! `»� ?f �.^�,. .,.._.�.,::' i.r..::'`rte, ,M1 + $. ,'r r} t - X�� L J r ; .
T
Change otitsp-Odential air,C.6nditiOning system
T1> r 3:
.- ss
.. BRI '�.r�� N �1AI'�lt
,... '
ditiona wor• to e
ertorrn ut er ��s perm t c ecK a app
F fVAC. LJ Gas Taitik Gas Piping _5#�utters Windows/boors'
(`
.Blectric ' : Plumbing pd : . LJ Generator hoof' 'Raof:pitch..
Total Sq.Ft.of Construction: Sc.Ff.of First((Fl�oor:�
'Cost of Construction:$ 4500 Utilities:�Seaver LJSeptit� 8uilding.Height:
Fgti-g 1w.`
._ _:... _
Name Sandie SGh,dlec:.: Name t7avrd Kruse .:
Address 16 Temple Avenue Company AC fJoctars Inc
State:FL Address,.1853 B�Itmoie street
Zip Code:.'34982 : F?x; Cityi..Port-Saint Lucie: State;Ft. _
7:2 777 6ib9 3�i984
i Phone No. - - Zip.Code: Fax:
_F-Mail•onthegosandie@yahoo.com Phone No..772.344-3944
lacdoctorsinc mail.com
Fill i :. '...
n fee simple Title.Holder.on next:page(if different: F-Mail: �g
from the,0.uuner lister! above). State or County License:
CAC 058461
if value of construction is$2500 or:more,a RECORDED Notice of Commencement is required,
To: Page 4 of 4 2019-07-03 21:06:47(GMT) 17726735762 From: DAVID KRUSE
UPLEIIENTA7( $fitft�UTICNIllUll; ITlft�
DESIGNER/ENGINEE-R: T Not Applicable IVIdRTGL*GE:CC7itAPAIUY. � Not Applical Ie�
:NaIT)e::SandiaS&Acier Napie Davio1%se.
Address:lOTrnpleA:renue,I'rIF'IE7C9,rL'.., sz Address: dTempk..kvelwe
City:: ForiPierce State; I-„-...... City;.Oat saniLucie _-State,.
Zip: 34051 Phone Zip: Phone:_
FEE-SiMPLE TITL ! OLDER. __ i�I.0 l�pplica:ble BONDING CC1WANY:. T,Not:Appli€sable
Narne:. tiiame:.
:address:tBs3131ft se:siraet Addrel
City: gity;'
:Zip; azho�c: Zip: Ph0n6:.
.4W NER/CONTRACfOR-AFFID:VIT At;plication.is liercby.rimade to obtain a:permit to do the wcirk and instalEation as Indicated.
E:certifythat do i�rgrx or installati , has.can7menced piioi tti.the isstiai�4> of a:p ririit:
5.t,_Lucie 4truntti rrtakes..no representation that.is granting a permit wi41:apthorite the ermitf�old'er;to build the subject structure
which isin:con lirt.witip any ate{�llcahle.}lome..bxrners Asaoctati.on rules,bylaws or an covenants that may restrict or prohibit. ucb
.st:ructurie.Please consult with your Home Qwners Association.and review .q4[deed,for.any ri?strictitins VvNch.mly,. .
In consi.deration.of the:granting of;this rmquest.ed perp it,l do hereby agree.that l will,in all respects,perforrtl tite.+york
.in accordance with the.approved plans,:tlie:Florida.8uilding:CodQs ani St:Lucie Qni'' An ridn�ents.
The followin wilding per[nit:applications.are exempt from undergoing a full concurrency.revipur,:roam additions,
accessory structures,swimmihQ pgols,fences,waits,.signs,screen:rooms.and.accessory uses.to..a.nother non-residential use
WARNI.NG.TO OWNER:Your.failure to'R.ecord a Notice of Cotnmence ment.may result in your paying'twice.for
improvements to your:property”A.Notice.of Commencement must.be.recorded.and posted an:the Jobsite
before:t�►e first inspection if•you intend to obtain financing,.cansultw.itl. lender or an attorney before
tbrnrnencin work-or recording.'Vour Natice of Comrriencement:,. .
f Stg.niittire.of owner/'L!assee/Contractor as Agent for Ov�ner' Signature cif.ContTactorIl.icense Holder'
I STATE OF.FLORIDA 5TATE.OF.FLORIDA
C.EyUNT'
OF-
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TY d31'
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ITtiefr3rplsirtstrut�ientp,,as.acknowledg .d.before:nie Thc,fof ingipstru a �,uas:acicnowledgedbQfpienie i
xliis - =day olr -•I. 20 ,,..4y this�y of� �_ i `20�6y i
Naive of person retaking statement 4Name of pe sort making.statement
4 ( PersonaliyKriowvri. 10. oclucea ldentification,`�� . Per'(orally Known � OR.ProdYg0jdeptificatir�n
Type flf.li entification T, of td gjficatior i
Praduc d. r .. Pro.'uced
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(5}nature.of:Notai 'pbiic-:Beate p.t :oeirfe.j.`: t. b.li -State.ofFlorida}gi re f:Not{Sfu :.
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.Commission to �e`, �,�1 e71)o t#r L: Raq A+ '.Commission N� u� [)
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G(3EJNTE l REVIEW -VIEW:REVIEW REVIEW �RCClIEW REtC1J
DATE ( � .
RECEIVED
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