HomeMy WebLinkAboutPermit App Schmitt ResidenceAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 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 Commercial Residential
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 670 I&CI A C • rr t&l' - y?S57/
Property Tax ID #: � .1d�.� CEO 7 � 6 A0 Lot No. 849
Site Plan Name: 4// Block No.
Project Name: in% Azan Se km l l:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters ✓Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator — Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
/ L l Qo
Cost of Construction: $ 1 7%� • Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name !'
Name: Ray Reinhard
Address: O !/1
Gt 16u •
Company: HBS, Inc.
City: a2 State: F
Zip Code: j r Fax:
Address:722 3rd Place
City: Vero Beach State: FL
Phone No. J� Q Jam, JrOT�r
Zip Code: 32962 Fax: 772-778-3514
E-Mail: r'5
Phone No772-567-7461
E-Mailtammyc@hbsglass.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County LicenseSCC131151281
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:_
Address:
City:
Zip:
Phone
Not Applicable
State:
FEE SIMPLE TITLE HOLDER: _Not Applicable
Name:_
Address:
City:
Zip:
Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:_
Address:
city:_
Phone:
Not Applicable
ate:
Not Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
1 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 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 JOB SITE BEFORE THE FIRST INSPECTION, IF YOU INT TO N FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR N E O CEMENT."
Signature of Owner/
ctor as Agent for Owner
STATE OF FLO I
COUNTY OF_ ,QLEMAEL
r/License Holder
STATE OF FLORIDA
COUNTY OF�nd�anRi�e�
The for ing instrum t was acknowledges before me The fo ing instru nt was acknowledged before me
this day of U 20 K�Jby this day of 20, s�' �Jby
Name of person making stat�eme t.
Personally Known ✓ OR Produced Identification
Type of Identification
Produced/
(Signature of Notary
07ky^'.�^y.,
Coml'1115SIQn' No. Notary Public stag of Florida
' � Tammy C Cnc�lish
My Commission GG 906987
Name of person making stat�eme�nt.
Personally Known ✓ OR Produced Identification
Type of Identification
Produced
(Signature of Notary P blic- S W of Florida )
CoM S IR1t♦Ji0. Nola PublicStateofFlonda eal)
Tammy n9 t
y My Commission GG 9069f37
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SUPERVISOR
PLA
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MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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