HomeMy WebLinkAboutBUILDING PERMIT APPLICATION T'
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ALL APPLICABLE INFO MUST B ED FOR APPLICATION TO BE ACCEPTED
Date: �A„�l �018 Permit Number: ID V
6I',Lucie CoueRf
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 x
PERMIT APPLICATION FOR: Window/door
iPftOPDSED lNf?�t01/�MLN�"LOCATION F� O -
s3 -� s
Address: 4712 Sunset Blvd, Ft Pierce, F1.34982
Legal Description: Indian River Estates-Unit 07-BLK 41 Lot 14(MAP 34/02N)(OR 635-2388:778-2867;3575-467:
3791-1015:3857-73;3903-891
Property Tax ID#: 3402-608-0115-000-8 Lot No. (r{
Site Plan Name: Block No. 1
Project Name:
Setbacks Front Back: Right Side: Left Side:
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ti
Installing-non impact windows and storm panels on the home.
CO�,I�TRU.CTtO N4 WORMATIOiV""�
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Aciditional work to be--r)-erformed under t ispermit-check all that apply:
❑HVAC Gas Tank Gas Piping Shutters t'�t Windows/Doors
r.
Electric Plumbing Sprinklers El Generator E] Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
w
Cost of Construction:$ S(`j�U Utilities: Sewer OSeptic Building Height:
x
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Name 7&ArI Q 1 ei-AhC QJCo Name: av'hr D E (-'rA etc es6- (_,
Address: L11 S k nS4T d3 V Company:ac k#, 13 1"! rIZIO C QSe - C0AS?'_,7^C
City: _p T -P+2 O'c" State: R/4 Address: Lf 112 _V ti.h 5 T 8 V
Zip Code: 2 L/g n Fax: -7 7,2L 46 City: F rt P i Q rcA- State: MCA
Phone No. Z. 1 S " 3 `1!� Zip Code: 3 !J??)L Fax:'111 - qGS 72 4C
E-Mail: -_ 1'1r/b Phone No. -7-1 2 a-CS 3 c7a
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: [ 2 C_ < 3)L
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL`CD -l1/IRTION
DESIGNERXMIGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address:4712 sunset Blvd,Ft Pierce,Fl 34982 Address:
City: State: bty: 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:
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 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.
Signature of Owner/Lessee/Contractor as Agent for Owner ignat a of Contractor/Licen der
STATE OF FLORIDA STATE OF FLORIDA_ j
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The for ing instru knowledged before me
this day of 20_ by this day of 2QJA by
Name of person making statement Name of perso making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identificatioj
Produced Produced L�
i
(Signature of Notary Public-State of Florida) (Sign q g o lyotary
LEN AUG
* - •eState of Florida- �N
Commission No. (Seal) Corn - P' Com NG 2otary Pui 1)
OF Flo��
°IX Y�Commission Expires
October
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17