HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I,,
Date: r• It,, I Permit Number: I I O �Mob
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Building Permit Application ��
Planning and Development Services PI=R�7I s i i�;w
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Gas piping E.
PR3PdS'ED INIROVEMENT-LOCATIO':N: a,
Address: 10720 Grey Heron Court, Port St Lucie. FL,34986
Legal Description: -c a Las*tAmio
Property Tax lD#: UV XD500 qo(� Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
D1=TAII.E'D DESCRIPTION QF WORK
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G3N5TRUCTIN`INFORMATIONT
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itiona workto e n e orme under this permit—check a apply:
1]HVAC 0 Gas Tank �✓ Gas Piping _Shutters Q Windows/Doors
Electric El Plumbing Sprinklers 11 Generator E] Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 695.00 UtilitiestSewer Septic Building Height:
01NEft/LESSf,E; Ta CONTRACTQRa V
Name Claude Wittman Name: Robert Binkowski
Address:10720 Grey Heron Court Company: Energized Gas
City: Port St Lucie State:FL Address: 4252 Bandy Blvd
Zip Code- 34986 Fax: City: Fort Pierce State:FL
Phone No.401-952-0887 Zip Code: 34981 Fax: 7723186672
E-Mail: Phone No. 7728773440
Fill in fee simple Title Holder on next page(if different E-Mail: Antonella@energizedgenerators.com
from the Owner listed above) State or County License: FL34747
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUaPPLEIVIENTAL�CONST�RUCTION LIEN LAW INFtJftMATION= I ��
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DESIGNER/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: 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 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
commencin wor r recording our Notice of Commencement.
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Sig ature of ner/ essee Contractor as Agent for Owner Sign ture of Contractor/Li ense Holder
STATE OF COUNTY OF FLORIDA A'ill� COUNTY OF STATE OF FLORIDA / (A A L I�
The f ing inst um nt was acknowledge efore me The f r oing instr ment was acknowledged before me
this day of 20 by this�day of 20 by
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(Na of person acknowledgin ) (Name of p rson acknowledging)
(Signature of Notary Pub' - tate of Florida) (Signature of Notary Pub[' tate of Florida)
Personally Known OR Produced Identification Personally Known R Produced Identification
Type of Identificatio Type of Identification Produced
Notary Public State of Florida
Commission No. Antonla($l Wla Commission No. ea
My commission FF 191201 �N'otary Public ace f Floridaaad� Expires 02127rz019 ;4 F; Antonia Ni POula
—M 04 0%AA n FF 191201
app Expires02/27/2019
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
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