HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
0
VI/
Building Permit Application
Planning and Development Services APR 12 2011
Building and Code Regulation Division P= -
2300 Virginia Avenue,Fort Pierce FL 34982 St. 1.:c
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential YES
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION,:.
Address: 4915 Seagrape Drive, Fort Pierce, FL 34982 d I
Legal Description: Indian River Estates-Unit 7-BLK 27-LOT 44(MAP 34/02N)(OR 3958-323)
Property Tax ID#: 3402-608-0039-000-1 Lot No.44
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Site Plan Name: 4915 Seagrape Drive Block No. 27
Project Name: Petersen Residence
Setbacks Front a5 i Back: 5 Right Side: 7 •S Left Side:
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DETAILED DESCRIPTION OF WORK:
New Residential, Home Construction
0 2A-Tf f- 410 6AWA --
CONSTRUCTION INFORMATION:
Additional work to e e orme under this permit—check a apply:
R]HVAC Ei Gas Tank Gas Piping _Shutters ✓Q Windows/Doors
Electric 0 Plumbing Sprinklers 1i Generator FVI Roof 3.5/12 Roof pitch
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Total Sq. Ft of Construction: 2399 S Ft.of First Floor: 1327 1
Cost of Construction:$ 144,000.00 Utilities: _Sewer Septic Building Height:
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OWNER/LESSEE: .CONTRACTOR .
Name Clifford and Ann Petersen Name: Stewart Cooper
Address:2213 River Branch Dr Company: Cooper Enterprises 4.6, LLC
City: Fort Pierce State:FL Address: 2511 SW Regency Rd
Zip Code: 34981 Fax: City: Stuart State:FL
Phone No.772-595-1907 Zip Code: 34997 Fax:
E-Mail: Phone No. 772-600-5300
Fill in fee simple Title Holder on next page(if different E-Mail: stewart@cooperentlic.construction
from the Owner listed above) State or County License: CBC 1260066
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION,:,,'',
NFORMATION: . -
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: 1 State:
Zip: Phone: Zip: Phone: I
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 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 restriction's 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.
s
ignature of Own e see/Contractor as Agent for Owner Signature of Con racto /Licen a Hol i der
STATE OF FLORIDA/ STATE OF FLORIDA
COUNTY OF :Xk w(°)Ir COUNTY OF 11rt Ll]C E
The forgoing instr ment wa acknowledged before me The forgoing instr ment was acknowledged before me
this day of i 20 J rby this day of ! 20 by
CAM3ex-
(Name of person acknowledging) (Name of person acknowledging)
S �(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification ✓/ Personally Known OR Produced Identification
Type of Identification Produced —,,_Type of�ldentification Produced
KAREN S. NIE?SEN
Commission No.' "" I) mission 4 FF 11Gor7Pmi ¢ion No. """""-, REN S. NIELSEP
C o m .aY°�s a ° My Commissioi f,plies i a? �:
_'a *_ Commission# FF 1156
2018
�� ' 1111111` June 12, 2018
Revised 07/15/2014
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW 5EVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE '�
INITIALS �
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