HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dater Permit Number:..
..
Building Permit Application .
Planning and Development Services
Building and Code Regulation -Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462'1553 Fax: (772) 462-1578 :CClmmerCial .Residential %K.
PERMIT AP,PUCATION -FOR:: f3siliill
PROPOSED ,IMP,ROVEMENT LOCATION.
:Address: �43 CAMiIiN(9-DEL RKO.
Legal Description: ITI19N7.;/IT�QJAIIhIiI,P.//[IADE
Property Tax lb #: -34127111f11AW241016 . Lot No::
Site Plan Name: SPARLSH I<AK« Block No.
.Project Name: WERFRONT
Setbacks Front29' Back: 23' Right Side: 17' Left Sider 17.
DETAILED DESC„RIPTION OF WORK.,TP
R€ LLACEE l;IENjF HOi IE SINGLE IFAMIVY IR ESIDENCE
2 BEDROOM 12 ONTH / OARAGE .
NO SLA8 TO BE. OUJIL1T OFF RRLEA�R OF.MGM E .
CONSTRI) ,TLONINFORMATION
Additional,workto e e orme under tis*permit—c ec :a apply:,
®HVAC Gas Tank Gas Piping Shutters Q Windows/Doors
❑ .
Electric D Plumbing . ❑Sprinklers �-Generator Roof
Total Sq..Ft of Construction: 2,11t1x8 S . Ft. of First Floor:��
Cost of Construction: $ ����' " Utilities;�Sewe: ISeptie Building. Height:
OWN ER%LESSEE.
CONTRACTOR:
NarrieWYN-Wi AI;LLgI;AIG(WRFOR,AT{,O, I
Name; NAT WVY[I.i_WMNIr . .
Address: LJi O WUTIHI USiMt�tYi .- 1600TI F-A92
Companys i�Qw'�NITWAPORNAXIION' .
City: PORT 6T, ILIVI Ole .. State: ��
Address: WN SOUTH W lHIJIJIY� .. I �WIIM4(02
Zip Code: 4 2 : Fax. 7 �7$-7� f
City: IP�QUIS L.W,�1tE .. State: IPL..-
Phone No.J(M.87ffi-5511
Zip Code: 344952. Fax: l(T7 ),S7A-7j(W
E-Mail:
Phone No. l(772.)87 113.
-Fill in fee simple Title Holder on. next page ( if different.
E-Mail.:..
from the Owner listed above)
State or County Licenser
If value of -construction is $2500 or more, a RECORDED NoticedCommencement.is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
.,
3 . �:.... �...� . P ..;... , a
DESIGNER/ENGINEER: _ Not -Applicable
MORTGAGE. COMPANY: X Not Applicable .. .
.:Name: A3RAREN,&iBRAOSty .
_
Name:
Address: 000,00 1SLUTAvE.
Address:
City, STUART State: !FL
City: State: -
Zip: 3-4996 Phone: f(7a.2>)aa,7�2a8
Zip: Phone:
:'FEE.SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY:.. _Not Applicable
Name:''
.
Name:. .
Address:-
Address:
City:
City:
Zip: Phone:
Zip. Phone:
I certify'that.no work or installation has .commenced -prior to the issuance of a permit.; .. . .
St: Lucie County make's.no representation that is granting a.permit will'authorizethe permit holderto build the subject structure
is in Home Owners or
which conflict with any applicable Association rules, -bylaws 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'l will, in all respects, perform the work
in accordance with the approved plans; the Florida Building Codes and St. Lucie' Couilty:Ameridments.
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 inspection. If. you intend to obtain financing, consult with Lender or an attorney before
commencing work or recordin .: -our Notice of Commencement'.
Signature of Owner/Agent/ Lessee
Signature.of:Contractor/License Holder.
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF ST. {emue iE
COUNTY OF Sr- kmy e
The forgoing instrument was acknowledged before me ,.
The forgoing instrument -was acknowledged before.me
-this ;I v day of Su +�I- Od�`bl>ay
this L24 day.of act may20_" by
LYLIr.Il�A
C.F' AQ ;� , i
(Name of person acknowledging)
(Name of person. acknowledging)
(Signature of Notary blI State of Florida j
(Signature No Public- State of Florida)
of
Personally Known OR Produced Identification
Personally Known ✓ OR Produced Identification
Type of Identification, Produced
Type of Identification Produced '
Commission No. •"�"' . -= OROTHYASKIN
. ,.•<r�l:eye•� DOROT I BASKIN
Commission No. . �: ��•. j�'�''
MY COMMISSION # GG
'?� ••�,' MY COMMISSION #.GG 030145'
:... 030145
c` EXPIRES:October2.2020
g,
s,�;F�� ¢:� �•'• Bonded Th-ru Notary -Public underwriters
m
ReAJ s&d 07,
REVIEWS,
FRONT:
ZONING
SUPERVISOR
PLANS
VEGETATION :
SEA TURTLE
MANGROVE:
COUNTER
REVIEW
REVIEW -.-REVIEW.-
REVIEW-REVIEW_'REVIEW'.
DATE.
cam PiLETIE
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