HomeMy WebLinkAboutBuilding permit app ALL APPLICABLE INFO MUST BE COMPLO FOR APPLICATION TO BE ACCEPTED • 1�( r'
Date: ` ��^1T_ Permit NumbeRECEIVEDi
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Building Permit Application Jqy 13 2011
Planning and Development Services
Building and Code Regulation Division PERMITTING FL
2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie County,
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 6740 North Al A, Ft. Pierce, FL 34949
Legal Description: 03 34 40 S 125 FT OF N 400 FT OF GOVT LOT 1 LYG E OF Al A(1.54 AC)
(OR 3891-2111)
Property Tax ID#: 1403-120-0003-010-3 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF`WORK:,.. ` F
o01F
-Tear Off,Inspect pIlmod dlbwn 10 code 170 11
- D in w1+h MTS I�ec,l-n-{ ctc �7
lnl ull all ntw f-Iashlrgs and vents
lost-All - D32 Kynar Cooi teq ItIuminUrn -'nap Lock
CONSTRUCTION INFORMATION:
Additional work to be nertormedunder t is ermit—c eck all thatapply:
IIHVAC Gas Tank as Piping _Shutters Windows/Doors
OElectric 0 Plumbing OSprinklers Generator Roof 6/12 Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor: j
Cost of Construction:$ 54,750.00 Utilities:ISewer Septic Building Height: 2 StOiry
II
OWNER/LESSEE. CONTRACTOR:
Name enne a issa ooper Name: Michael Black
Address:4085 Shields Road Company: MB Enterprises Rooting & Sheete a,
I
City- Canfield j State:_ Address: n Street
FL
Zip Code: Fax: City: Vero44406 eaC State:
Phone No. Zip Code: 32962 Fax: 569-4"IT1
(772) 562-7549
E-Mail: Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail: blac mrm comcas .ne
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEfVIE 'TAL CONSTRUCTION
LIEN LAW INFORNiAT10N:
DESIGNER/ENGINEER:' _Not Applicable MORTGAGE COMPANY: Not Applicable it
Name: Name:
Address: 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:
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie Count 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 inspection. If you intend to obtain financing,consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
A�S
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Signature of Owner/Lessee/Agent Si nature of Contractor/Incense Holder
STATE OF FLORIDA STATE OF FLOR O
COUNTY OF COUNTY OF v LUC�,I F.
The for oing instrument was acknowledged before me The forgoing instr ment was acknowledged before me
this T day of mot---� 20 L3y this�day of 20 f by
(Name of person acknowledging) (Name of person acknowledgin )
ICI
- ;- ry
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(Signature t P li - t to Q&tg (Signatur of Notary Public-State of Florida)
Personally Known r^�u=='-!° asta€ie&ki ` nally Known OR Produced Identification
Type of Identification Produ d .ao"'ew,p, (,%RIFI IlTlyp of Identification Produced
io Wary Public,State of FI ride � !!
Commission No. ' e mMlsslon No.FF 968 60m fission No. 1
KAREN S. NIELSE
pfw+.� �My Commisslon Expires 0 08120
Commission# FF 1115
ns = My Commission xpn
Revised 07/15/2014 ;;��� June 12, 2018,
REVIEWS FRONT I ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE',
COUNTER 1 REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETEi �
INITIALS
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