HomeMy WebLinkAboutBuilding Permit Application i
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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
17
Date: 7 4� ! -1 Permit Number:
RECEIVED
4
OCT.0 9 2019
--- - — Building Permit Applicatooh
Planning and Development Services Permitting Department
Building and Code Regulation Division !W@10 Geanty 4
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential +�
PERMIT TYPE:
' PRC?POSED`IMPRQUENlENT k0,QTT
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Address: a�0_. NWV
Property Tax ID#: - ( -Q )- Lot No.
Site Plan Name: !(1 Block No.
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Project Name:
E
D`ETAILED�DESCRIPT1aN fJF 1N�RK, _ _
off,
CONSTRUCTION IN;fiORMATION
Additional work to be performed under this permit—check all that apply:
—Mechanical ^Gas Tank _Gas Piping —Shutters Windows/Doors
Electric Plumbing _Sprinklers ^Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor: I
a
Cost of Construction:$ d�, =` Utilities: —Sewer _Septic Building Height:
777
01NNER/LESSEE r CONtMI TORI-,
Name rI.LName:Ray Reinhard
Address: /Z 60Y Company:HBS, Inc.
City; 1 ey'C,z. State: Address:
722 3rd Place L
Zip Code: q4`1 i Fax: City: Vero Beach State:FL
Phone No. S&—q- 5 I Zip Code: 32962 Fax: 772-778-3514
E-Mail: _�Qt ��lti l}'tt'rY`i/l 64t'1'1 PhoneNa772-567-746!
Fill in fee simple Tittle Holder on next page{if different E-Mailtammyc@hbsglass.com
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from the owner fisted above} State or County License SCC131151281
1f value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
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5U P_FI ENIENTA CC}.1�1S i RUC I ION:LIEN L1111U IIFQRMATIO:I� _
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: i Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: 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 COMMENCEIWENT MAY RESULT IN YOUR PAYIING
TWICE FOR IMPROVEr',NENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTIOM. IF YOU INSTAIN FINANCING, CONSULT
WITH YOUR LEN ER OR AN ATTORNEY BEFORE RECORDING YOUR `�EIMCEMENT."
Signature orbvingl Lessee Contractor as Agent for Owner Sigifture of Contractor/License Holder
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STATE OF FLORIDA � STATE OF FLORIDA
Gt
COUNTY OF �T COUNTY OFIndianiuver
The forgoing instr ment was acknowledge before me The f Ding instrum t s acknowledg afore me
this of 4,h �,20[ by this day of 20by
C-se-ne R05�; 0,4mMilAl1,A MAr_ a/
Name of person mak7011
te ent. Name of p so m��ced
Personally Known Produced Identification Personally Known Identification
of Identification Type of lden 'fication
ProduUd Produced —
Fv
t�
=Comm -,
Notary (Signafi r i o f or a
.,S�jiYrU•,.. JULIE BARRETT
gt„..
?�;,y.,.r? Notary Pu¢�j��c•�{ate of Florida � otary Public State of Florid
o. -�: tommiM&PAJGG 243242 Commi Tammv['�n^fish t e8)
9'Foa n°4' My comm.Expires Sep 28.2022 rA My Commission GG 906987
r N i ra:Notary Assn. '�t Expires 01/23/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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DATE
RECEIVED
DATE
COMPLETED
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