HomeMy WebLinkAboutBuilding Permit Application5UPPI..EMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNERIENGINEER; x Not Applicable
MORTGAGE COMPANY: � Not Applicable
Name:
Name; MYNETHOMkS BARNIM
Address:
Address:
City: — State.•
City: HOE tY++uoob State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name'
Name:
Add ress: 3044 SW 42ND ST
Address:
City:
City:
_ _ _
Zip: Phone:
Zip: Phone:
OWNER/ C;ONTRACTORAFFIDVIT: 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 priorto the issuance of a permit.
St. Lucie Count4r makes no representation that is granting a permit will authorize the permit holder to build the subject structure
ssttructis in u re. Please consult withpyollur Home Owners Association Association
vMew your deed focovenants
any estrr tions whlchtrmsy appp�h iblt such
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, wails, signs, screen roams and accessory uses to another non-residential use
WARNING TO OWNER: Your fallure 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 finan consult with lender or an attorney before
commencing work or recording your Notice of Cornrnen consult
STATE OF FLORIDA
COUNTY OF 5:0*04
as Agent for Owner
C. Lw--k
The forgoing Instrument was acknowledged before me
this 'a dayof 4 20M by
Name of person making statement
Personally Known r OR Produced Identification
Type of identification
Produced
(Signature o MA�ETHE BIRKINS
/
CommissionNFY 13318NIrP419448
REVIEWS
Rev. 8/2/17
EXPIRES July 02. 2021
Contracto
STATE OF FLORi
COUNTY OF - (! L 4 Q
The tWUng instrume s owledgtd before me
this = day of 4 20 r by
Name of p aking statement
Personally Known OR Produced Identification
Type of Identification
mmission
MIGUEL. A
EXPIRES April 19. 2021
FRONT ZONING PLANSCO NTER I REVIEW I REVIEWOR I REv W I � EVIEWON I � REVIEW E I
MREVI WVE
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
- Building Permit Application
Planning and Development Services
9ullding and Code Regulation Division
2300 Virginia Avenue, Fort Pierce Ft 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
LPiC)POSEC� #MIiOVEMINT LOCATION:
Address:
Legal De
Property Tax lD it: i �,^ �U- 71! —71 Lot No.
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Par s'a e
CONSTRUCTION INFORMATION:
A-daltionalwor o be orme OMER
s errn —c
I�HVAC GasTank �GasPiping
Electric Plumbing []Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $
Obi NERA SSEE:
Block No.
, , liv i-, ;��� S t2z
Shutters Windows/Doors
Generator E Roof Roof ply+
S . Ft. of First Floor:
Utilities. 5ewer Septic
Name 4" VV IC3 a 9
Address:
City: Stater
Zip Code: Fax:
Phone No.
E-Mail:
Fill In fee simple Title Holder an next page (if different
from the Owner listed above)
CONTRACTOR:
Building Height:
Name: WAYNE THOMAS BURNETT
Company: FHIA.LLC
Address: 3D44 SW42ND ST
City, HOLLYWOOD State: FI-
zip Code. 33312 Fax: 954-792-7977 .^
Phone No. 954-792-4415
E-Mail: PERMITS@FHAPRODUCTS.COM
State or County License; CGC061890
If value of construction is $2501) or more, a RECORDED Notioe of Commencement Is required.