HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7 Permit Number: 1—7LOCO
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Building Permit Application 11017
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 --4 Residential
PERMIT APPLICATION FOR: Alteration
PROPOSED I;MPROUEIVIfNT LOCATION
Address: 1321 Lancewood Terrace, Palm City, FL 34990
Legal Description: Harbour Ridge-Plat 9-Lancewood village Unit 11 or 3990-101
Property Tax ID#: 4426-804-0021-000-1
Lot No.
Site Plan Name: Refitt Residence Block No.
Project Name: Reffitt Residence
Setbacks Front Back: Right Side: Left Side:
RETAILED DESC lPTION�.OF WORK;,
CO'NSTRUCTfQN INFORMATION4.
Additional work
or to be ertormed under t is permit—check all that app y:
F]HVAC Gas Tank Gas Piping 1:1_Shutters windows/Doors
Electric 0 Plumbing Sprinklers 11 Generator E Roof Roof pitch
Total Sq. Ft of Construction: SnSewerE]
of First Floor:
Cost of Construction:$ Utilities: _ Septic Building Height:
j OWNER/LES,SEE _ ;; t CQNTRACTOR 7T - -
Name Donna& Ronald Reffitt Name:
Address:1321 Lancewood Terrace Company: 2� . OS
City: Palm City State: FL Address: JS
Zip Code: 34990 Fax: City. State:_EL
231-499-5042 2 c�
Phone No. Zip Code; -�'T tcl Fax:
E-Mail: Phone No. �� — ��—�` �� , \
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: (�C^(�� ���Cl C
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
i
r
SUPPLEMENTAL CONSTRUCTION l IEN L4W INFORMATiO`N
DESIGNER/ENGINEER: x_Not Applicable MORTGAGE COMPANY: `Not Applicable
Name: ' Name:
Address: \ Address:
City: State:—C_ 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:
a
1 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
commeni; ork or recordin our N_o ' _ _of Commencement.
Sigatufe of Owner/Less -Cont ornctor s Agen Owner ignature of Contractor/License Hdlder
STATE OF FLORID %` STATE OF FLORIDA ;
COUNTY OF �� :� COUNTY OF
Theh!dayof_
ing instrument was acknowledge before me The forgoing instru ent was acknowledgedbefore me
this I T1� �� 20 �by this day of f' 20 by
(NamIrsonacknowledgin (Na of pr on acknowledging)
': F
;t t•,••co ,p
(Signature of Notary Public- a f� }, F� (Signs re of Notary Publi to of Florida)
Personally Known OR Produc ( rf ci n Personally Known OR dentification
Type of Identification Produced Type of Identification P oduced
Btu
Commission No. (Seal) �°soQ6�,O Commission No.
Revised 07/15/2014 s � �;�"�•'
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION ;SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS