HomeMy WebLinkAboutBuilding Permit Application i
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED d
Date: 03/27/2017 PermitNumber:
RECEI`.
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 Commercial Residential Yes I
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line !
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Address: 7967 Plantation Lakes Dr,Port St Lucie, FL
Legal Description: Reserve Plantation-Phase IIA-Lot 59(map 33/28N)(OR 3446-334:3628-2902)
Property Tax ID#: 3321-803-0063-000-9 Lot No.
Site Plan Name: boundry survey Block No.
Project Name: Spec house
Setbacks Front 10'min Back: 165' Right Side: 10'min Left Side: 460'
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Install new 500 gallon LP tank UG, install new interior and exterior LP gas lines and connect
appliances
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Additional work toeDer Orme un ert is permit—c ec a appy:
®HVAC L_I Gas Tank ZGas Piping _Shutters ®Windows/Doors
11 Electric 0 Plumbing Sprinklers 11 Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 6979.00 Utilities:11Sewer 0Septic Building Height:
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Name 16 Name: Brian crltoph
Address: Company: C and C Diversified i
City: 4/&lie s6 a x, %P L State: Address: 7954 SW Jack James Dr
Zip Code: Vie/ Ste— Fax: ffA �;G/ 6S'0 1 City: Stuart State:FL
Phone No. 7 7 V G 2 G 7 Zip Code: 34997 Fax: 772-266-4679
E-Mail: A G111 !Z 6 Phone No. 772-266-4680
Fill In fee simple Tale Holder on next pa e(if different E-Mail: info@candcdiversified.com i
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from the owner listed above) State or County License: 21079
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. siI
`'S.UP;P:LIENTALCO;N57RUCtIUN LIEN LAIN;.INFORNIATION:` is ;:.::: :;:•::: :'' `:` ::::
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State: ?
Zip: Phone: Zip: Phone: I
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City: I
Zip: Phone: Zip: Phone:
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 thepermit 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 inspect' . if you intend to obtain financing,consult with lender or an attorney before
commencing wor recorcling your Notice of Commencement.
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Signature of Own d essee/Contractor as Agent for Owner Signature of Co�n'ttrr'actdr/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ki, o-,'rl '~ COUNTY OF
The forgoing instrument was ac nowledged before me The forgoing instrument was acknowledged before me
this-nday of 0" 4{�C 20 1-2 this,�day of 24 /�y
2-:!!�7co r Fl4 Y, � a �
(Name of person acknowledging) (Name of person acknowledging)
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(Signature of Notary Public-State of Florida} ignature of Notary Public-State of Florida )
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
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Commission No. (Seal) Commission No. My MO N8FF944078
EXPIRES:January21,2020
% Bonded THru Nolaly Public Underwriters
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Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE s
COMPLETE
INITIALS I
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