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ALL APPLICABLE IN O MUs BE COMPLETED FOR APPLICATION TO BE ACCEPTED `7
Date: Permit Number: ` O
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: Building
PROPOSED IMPROVEMENT LOCATION.:
Address: 114 QUEEN-BESS COURT, FORT PIERCE, FL 34949 UL
Legal Description: QUEENS COVE - UNIT 2 - BLK 23 LOT E
Property Tax ID #: 1414-702-0023-000-6, Lot No. E
Site Plan Name: BACCI RESIDENCE Block No. 23
Project Name: BACCI RESIDENCE
Setbacks Front-29 �' Back: o�d Z Right Side; , Left Side: 110
DETAILED'DESCRIFTION OF WORK:
NEW HOME 40 �Fo Il C�)<
CONSTRUCTION- INFORMATION:
Acdditjonal work to be performed under this permit— check all that apply:
E
VAC ❑ Gas Tank. ❑Gas Piping Shutters Windows/Doors
lectric 9Plumbing F],Sprin/klers Generator. Roof 2-- Roof pitch
Total Sq. Ft of Construction: 2990 SQ FT ✓ S Ft. of First Floor:
Cost of Construction: $ 214,000.00 Utilities: Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR: .,
Name GEOFFREY & ELODIE BACCI
Name: WILLIAM T BROGNANO
Company: AMERON HOMES, INC.
Address: P.O. BOX 780874
Address: 5310 SW VALENCIA. SW LN
City: VERO BEACH State:. FL
Zip Code: 32968 Fax:
City: SEBASTIAN State: FL
Phone No. 630-726-2179
Zip Code: 32978 Fax: 772-589-1304
E-Mail:
Phone No. 772-589-12999
Fill in fee simple Title Holder on next page'( if different
E-Mail: AMERONH@AOL.COM
from the Owner listed above)
State or County License: CRC057392
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SU,PPL'E'M. `NTAL,CON•S.TR'UCTIO.N LIEN LAWINFORMATION:
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: ARTHURF.PRIEP Name:
Address: 8530 U.S. HIGHWAY 1, SUITE 8 Address:
City: micro State: FL City: State:
Zip: 32976 Phone: 772-883-6991 Zip:, Phone:
FEE SIMPLE TITLE HOLDER: - x Not Applicable BONDING COMPANY: x Not Applicable
Name:
Address:
City:
Zip: Phone:
Name:
Address:
City:
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. Pleaseconsult 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 your Notice of Commencement.)
as Agent for Owner I Signa`tKe of Contractor/License Holder
STATE OF FLORA STATE OF FLORIDA COUNTY OFCOUNTY OF 121,1 -
The. forgoing instr ent was acknowledged before me The forgoing instrument was acknowledged before me
this�day of � 20 Eby this, 6 day of 20 k' I by
�-SP-DLJ .R edge I a&�e,&1-4� VJ tliJt�-T ae+--D,�,no-lyLo
(Name of pers n acknowl dging) (Name of person acknowled ' )
(Signatu a of Notary Public- St too Florida) (Sign ture of Notary Public-.Stto of orida )
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No.
Revised 07/15/2014 .
.; KOSTINA L GRUNZWEJ(� Jmmission No.
MY COMMISSION # GG064 87
J�TINA L GRU
MY COMMISSION #
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