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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAB APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Planning and Development services Building and Code Regulation Dh4sion 23W Zrrginia Avenue, Fort P3ieroe FL 34982 Phone: (772) 462-1553 Fax: (772) "2-1578 PERMIT TYPE: PROPOSED IMPROVEMENT LOCATION: Address: 4703 Juanita AVE Fort P'ie=, FL 34946 Property Tax ID #f: 1431-703-0039.000-7 Lot No. 19 AND 20 Site Plan Name: 4703 Juas b AVE Fort Pierce, FL 34M Block No. B Project Name: Meleslo Chino; Keturah A Chino Permit Number: Building Permit Application Commercial Residential X DETAILED DESCRIPTION OF WORK: I CONSTRUCTION INFORMATION: I Additional work to be performed under this permit- check all that apply: __Mechanisal — Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Electric — Plumbing _ Sprinklers _ Generator X Roof Pitch Total Sq. Ft of Construction: Cost of Construction: $ 48.896 Sq. Ft. of First Floor. Utilities: — Sewer,Septic Building Helot- OWNER/LESSEE: CONTRACTOR: Name t ekwo Clan : Keturah A Guano Name: BURKE HAMMOND Address: 4703 Juanita AVE Company: FHIA, LLC City. Fort Now State: FL Address: 3044 sW 42 5T Zip Code: 34846 Fax: City HOLLYWOOD State: FL Phone No. � - 6 '} Zip Code: 33312 Fax: 407-47283$0 E-Mail: Phone No 954-7924415 Fill in fee simple Title Holder an next page ( H different E-Mail corn from the Owner listed above) State or County license W C -L l312's If value of HVAC is $7,W or more, a RECORDED Notice of Conunencement is required, SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNE ENGINEER: Not Applicable MORTGAGE COMPANY, Not Applicable 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: Zip: Phone: Z City: _ 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 pert will authorize the rmit holder to build the subject structure which is in con id with applicable Home Owners quod flan rules, bylaws or covenants that may restrict or prohibit such structure. Please consult your Home Owners Association and review your deed 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 Suilding 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, wails, signs, screen rooms and accessory uses to another non-residential use OWARNM TO OILIER' YOUR FAnAfiff TO RECORD A NDTICE OF MAY RESULT IN YOUR PAY= TtYtCE FOR fM11111M MENTS TO YOUR PROPERTT. A NOTICE OF "I BE RECORDED AM POSTED ON THE .JOB SRE BEFORE TILE FIRST pI11SPECT[I. R= YOU INTEND TO OBTAIN RMANCING, CONSUILT WFM YOUR LOUDER OR AN ATTO blEY BEFORE YOUR NOTICE OF " X 7Q�__4�j Signature o er/ Lessee/Can or akAgent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF Ise • l "f' P COUNTY OF Ci' The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this l` day of -_ 1�4 _ 20LL by this It day of _ t �r 20 2L by Name of per making statement. Name of person making statement. �.. ��11111H1111J11!/!� � Personal OR P, k Personally OR Produced W Type Produ f ntitication ``���� Q, �ssio may/ Type eu f tification X��Q�roLOI�///j/7i` �°-eR i - --� � •C�pt,�GH 10 '°i,Qi - ` � ♦ � * = � •ate �+`'" �� 'fN ; re WryPubiw j +y. y 9 �'r °nisi t1+�° �,.:�' `�� ry �� x 0748p /q -dUc, S�TAII) 1p�� ��� fission No. i��i ? �bifc 11nAa ,�. •0 O�O��� IN REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE "' WNGROVE DATE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW - ,-. RECEIVE©