HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 05 JUL 17 Permit Number:
s - __� _ ;- 062917 RECEIti"�D J�1[_
Building Permit Application
Planning and Development5ervices;_
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential x
PE MIT APPLICATION:1OR: To Select from dropbox, click arrow at the end of linen<a Q a a t
PROPOSED 114ROVEMENT LOCATION:
Address: 4949 N A1A,APT 154, FT PIERCE,FL,34949
Legal Description: BREAKERS LANDING UNIT 154(OR 3862-2502)
Property Tax ID#: 1414-602-0057-000-6 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
/dam Gv
CONSTRUCTION INFORMATION:
ACIClitional work to be erformed, under this permit—check all thal apply:
11HVAC Gas Tank ❑Gas Piping _Shutters l]Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq.Ft of Construction: &40 � S . Ft.of First Floor:
Cost of Construction:$ 2,400.00 Utilities:iSewer OSeptic Building Height: /yT�
OWNER/LESSEE: CONTRACTOR:
Name r Name: JON LEVASSEUR
Address: !`� �� Company: DECORATIVE CONCRETE
City: rL Stater Address: 1652 SW SCHLEICHER LANE
Zip Code: Fax: City: PORT ST LUCIE State:FL
Phone N�o.1/M Y�� ) Zip Code: 34984 Fax:
E-Mail:' �f'lf�G /1�Wj" r� °%'� Phone No. 772-216-6171
Fill in fee simple Title Holder on next page(if different E-Mail: EDEN68@AOL.COM
from the Owner listed above) State or County License: CBC 1260973
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: X 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
commencing work or recording our Notice of Commencement.
o
ure of wner/Lessee/Contractor as Agent for Owner Sll&dre of Contractor/License Holder
STATE OF FLOftkpA 1 n'' STATE O ORID
COUNTY OF 1.1.1LJ�)J OF_��. WU Q
The forgoing instr e t was acknowledgg before me The forgoing instru ent was acknowledged before me
this�J5day of 201 by this Say of 20 OL by
Join, u.y,
(Na of p rson ackr wledging) (Na a of person acknowledging)
L
(Signat(I of Notary Public-State of Florida) (Sign re of Notary Public-State of Florida) \`
Personally Known OR Pro uced Identification X�/ Personally Known OR Produced Identification
Type of Identification Produced F M,e p(AJ5ZJa6F Type of Identification Produced
Kayla Frank TARY PUBLIC
Commission No.�F � )NOTARY PUBLIC Commission No. ATE OF FLORIDA
STATE OF FLORI Cornm#FFM817
Revised 07/15/2014
04RE Mb Expires 9/30/2019 xp res
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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