HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: Cal . off? Q'
ni�i'pa�H
Building Permit Applicati In
gand Development Services JAN 3 12020
Building and Code Regulation Division
Permitting Department
2300 Virginia Avenue, Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial R9dWCik aunty, FL
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line 'E�� jay, I�)
Address: 1013 Copenhaver Road - Fort Pierce, FL 34945
Legal Description: Lot 13, Block 157 of Lakewood Park Unit No. 12
PropertyTax ID #: 2313-211-0006-000-7
Site Plan Name:
Project Name: Garage for Robert & Jennifer Jacquin
Setbacks Front 297.54 Back: 15.00 Right Side: 60.00 Left Side: 58.00
Po l7e�achPcQ - - kko_ 4a i
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HVAC L J Gas Tank
Electric Q Plumbing
Piping
1-1 Generator
Lot No.
Block No.
iouiloR,r•S w0'X gbx ,, .
i -
Windows/Doors
11 Roof = Roof pitch
Total Sq. Ft of Construction: 3200 S Ft. of First Floor:
Cost of Construction: $ 60,000 Utilities: []Sewer aSeptic Building Height:
Nam Robert and Jennifer Jacquin
Name: OWNER
Address: 1013 Copenhaver Road
Company:
City: Fort Pierce State: FL
Zip Code: 34945 Fax:
Phone No. 772-528-0801
Address:
City: State:_
Zip Code: Fax:
Phone No..
E-Mail: robert.jacquin@pjsi.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail:
State or County License:
1f value of construction Is $2500 or more, a RECORDED NO' Me of Commencement is requirea.
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DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Z__ Not Applicable
Name: Paul Welch, Inc.
Name:
Address:
Address:1984 S.W. Biltmore`Street
City: Port St Lucie State: FL
City: State:
.dip: 349RA Phone 772-370-5092 .
Zip: Phone:
.
FEE SIMPLE TITLEHOLDER: ,X Not Applicable
BONDING COMPANY: _X. Not Applicable
Name:
Name:
Address:
Address;
City.
Clty:
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.
S, Lucie CountyY makes no representation that Is grant ng,a ppermlt%I authgriae the permit:poldet�. tobuild the subjects1rructure
which is incontiictwith any applicable. Home Owners ssociatlon rules, bylaws or and covenants thatmay restrict orpro lbit 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 hereb; agree that 1 will, in all respects, perform the work
in accordance with the approved plans, the Florida Buliding Cgdes and St. Lucie County Amendments.
The following building -permit applications are exempt from undergoing a•fuil concurrencyreview: room additions,
accessory structures, swimming pools, fences, Walls, signs, seem 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 Cgrnmencelnent roust be recorded and posted'onthe jobsite
before the f t inspection. if you intend to obtain financing, consult lender Crain attorney before
m rnmonA , inrle Fir r,%rnrrlIna vnur Nritirwrif crimmenc6ment.
Signatur f Owner/ Lessee/Contractor as Agent for, Winer
Signature of Contractor/License Holder
STA OF FLORIDA
STATE OF,FLORIDA
COUNTY OF St Lucie
COUNTY OF St I iir.4p
The forgoing Instr ment was acknowledged tiefere.me
The forgoing instrument was acknowledged before me ,.
this mdayofnnianlr(4,' .2nLOby
this ____day of 2Q_ by
�1 c�in2r� c.c�u�h
Name of person making statement
Name of personmaking statement
Personally Known �_ OR Produced Identification
Personally: Known OR Produced Identification
Type of identification
Type of Identification
Produced
Produced
a) Notary Public Stale of FI
(Signature of Notary Public- StateL4P.*
,46ign ure of Notary Public- State of Florida)
�r AlyssaModme($eat)
Commission No. L�2,3—S IVy Commission GG 3
��� xpims 0411412023
'Vom -ssion No.
j
ici ia/ SOR 3
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17