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Home My WebLink AboutBuilding Permit Application ALL APPLICJMLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: /� Permit Number: RECEIV EC 14 1 oil Building Permit Applicatio SEP 2 3 2019 Planning and Development Services Building and Code Regulation Division Permitting Department 2300 Virginia Avenue,Fort Pierce FL 34982 ieCounty, FL Phone:(772)462-1553 Fax:(772)462-1578 Commercial es' PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line Address: 1JIJ 1AW L OhK M/L16 Legal Description: Property Tax ID#: g4o6- 605— v0 4, CO©— Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: _, � ,.._,..• _._._,ur.,.r� �.� �; ,..� .,.. _,� _.. _„ _.... .ter._� - - _ _ ,,:G. ._._,. :. M��iEP` &r�TN P.EMoDEt .L M©v'� a 1/,�N l L16HV Neu);..�s'1HAdsi r,40� , ,GF --r 2ECO hCr�Sj REI-OCAE o R�CEsS CftNS CO'NSTRUCTCON IN'EORMATION s . Additional wor toe e orme under t —checkispermit a appy: HVAC E]GasTank ❑Gas Piping _Shutters Q Windows/Doors RElectric 0 Plumbing Sprinklers FIGenerator Roof Roof pitch Total Sq.Ft of Construction: S Ft.of First Floor: Cost of Construction:$ V` Q Utilities Sewer 0 Septic Building Height: NameT'OFIN MOIZEL,ANfb Name: ARTHUR ENGELMANN Address: o10&H AM Z-Adl�L— 04/4 0J Company: ACCURATE ELECTRICAL CONTRACTING,INC City: PP<r.M CITY State: FL Address: 7193 GULLOTn PLACE Zip Code: -3 4910 Fax: City: PORT ST.LUCIE State:FL Phone No. 77a ag 3— 65�f?3 Zip Code: 34952 Fax: E-Mail: - Phone No. 772-878-9171 Fill in fee simple Title Holder on next page(if different E-Mail: ACCURATEELECTRICPSL@OUTLOOK.COM from the Owner listed above) State or County License: EC0003072 if value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPP EMENTAL C0NSTRUCTION`LIENLA1N,tNFORMATtONr d � y _ Y 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 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.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' spection. If you intend to obtain financing, consult with lender or an attorney before commencing k or recQ43ding your Notice of Commencement. Signature of Owner/ ssee/Contractor as Agent for Owner Sign ure ofC tractor/License Holder STATE OF FLORIDA STATE OF LORIDA4 COUNTY OF COUNTY OF The forgoing instr 1 lent w s ac iowledged before me The for oing instru ent was a cnowledged before me this day of 20 by this day of 20(,� by Name of perso making statement Name of person Vaking statement Personally Known ODOR Produced Identification Personally Known produced Identification Type of Identification Type of Identification Produced w Produce R �1tiHIVlR i G� IIIIIINyN �U��i • .. i (Signature of Nota PAI'(Signature of Notary Pu c-S` •Pll Ell • .•O ��4 ( g Notary .� Commission No. 'a c •; $ Commission No. (Sealf *• �IGG{31101 c Z 'v �,• Z i lie REVIEWS FRONT .�ISOR PLANS VEGETATION � iQr� ```MANGROVE COUNTER `BQ� 'Sj� IEW REVIEW REVIEW p�N REVIEW DATE IIIINI RECEIVED DATE COMPLETED Rev.8/2/17