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HomeMy WebLinkAboutScan0702ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: y l Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 3498.E Phone: (772) 462-3553 Fax: (772) 462-3.578 COCYII'd'lercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT La.CATI0N. Address: 1076 1 S OC�AM Dk A 7q Legal Description: Property Tax ID #fi: J-511— -6'%Q " M75— — 000 , 3 Lot No. _—� Site Plan dame: Block No. Project Name: Setbacks Front Sack: Right Side: Left Side: DETAILED DESCRIPTION OF WOORK:_ W P- L! l 17 ' J v1J I Ob P -�7 r H ti CONSTRUCTIONINFORMATION- Addifional work to beperformed under tispermit-checka appy: ❑Gas Shutters F-]Windows/Doors HVAC LJ Gas Tank Piping _ LJ Electric Plumbing OSprinkiers LJ Generator Roof Roof pitch i otal Sq. Ft of Construction: 0-0S�Ft.[ of First Floor: D Cast of Construction: 5 __ - Utilities_ —Sewer Septic Building Height: OWNER/LESSEE: Name �Ep� q i-l-EPE51) Address: 10701 -5 (YEAM b& city: ::5 -CO- 60 BFA CH State: -E]�- ZiRCode: 3249.7 Fax: Phone No. 765--2 l—�-- �3 Lf E -Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) CONTRACTOR: Mame: ARTHUR ENGELMANN Company: ACCURATE ELECTRICAL CONTRACTING, INC Address: 7193 GULLOITI PLACE City: PORT ST. LUCIE State: FL Zip Code: 34952 Fax: Phone No. 772-878-9179 E -Mail: ACCURATEELECTRICPSL@OUTLOOK.COM State or County License: ECO003072 if value of construction its $2500 ar more, a WORDED Notice of Commencement is required. a P L M NTAL Ct lVSTRtJCTI®N, IEN'LA f INFORMATION, 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: EEE SIMPLE TITLE HOLDER: — Not Applicable BONDING COMPANY: Not Applicable Name: Name- Ad d ress:7193 GULLOTn PLACE Address-, City: Gary: 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 ail 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 Raying twice for improvements tp_ our property. A Notice of Commencement must be recorded and posted on the jobsite before the first'i pection.If you intend to obtain financing, consul ith lender or an attorney before commendnEAv rk or re dine your Notice of Commencement_ / Signature of Owne Lessee/Contractor as Agent for Owner Sign ure of CQ ctor/License Holder STATE OF FLORIDA ./ STATE OF FLORIDA COUNTY OF ti COUNTY OF The forging instrument was acknowledged before me The foraoing instrumejt was acknowledg d before me this 1_ day f 20 2Cby this, __ day of 2 by Name of person makirgstatement Name of person maki statement Personally Known /, Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produce Produced r Y , r � 12' {signature of Notary Public- 5fate S (Signature of Notary Public- State OfFlorid Il I lHfi/��/ ,�,1R�y!!/��` Commission No. _NN' 'QF'5 5 � fo W"_ �,tyl�il Commission No. `N4© ,yl Z G4��9ER 22� r � g `�' ;r • � �V '���`�` cid _ o .. s• -AO _ —_ •a• .yt REVIEWS FRONT�'•-gO ffM1i1 1Q7 VISOR '•�,''4tn��,►�e'�IEW PLANS REVIEW VEGETATION REVIEW SE! �i� N�ajl} �.� COL)NTES'; ,'�p�o� a► BATE ry E,�" ........ �� y , • cn, `,ti RE=CEIVED DATE COMPLETED Rev. 8/2/17