HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR.APPLICATION TO BE ACCEPTED
Date:
Permit Number: �O '
RECE
Building Permit ApplicationNE®
Planning and Development Services OCT 1 - 2017
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 P E R NI I-F T I N G
Phone: (772) 462-1558 Fax: (772)'462-1578 Commercial Residential co: FL.
I PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line I
Address: 5212 Pinetree Dr Ft Pierce FL 34982
Legal Description:
PropertyTax ID #: 340260201780009
Site Plan Name:
Project Name: Rosko
Setbacks Front Back:
Right Side: Left Side:
Lot No.
Block No.
4ft tall wooden fence. 2 inch vertical boards with 3inch spacing between. Top and bottom horizontal supports only,
no center support. Two self latching gates that open outward.
Adaltional worKto oe ertormed under this permit —check all apply:
E1HVAC Gas Tank OGas Piping _Shutters Windows/Doors
11 Electric 0 Plumbing Sprinklers Generator F]Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ a �4 G . °G Utilities: Sewer Septic Building Height:
OWNER LESSEE
CON,TRACT�R
13 !>M„Y,
Name Cristina and David Rosko
Name:
Company:
Address: 5212 Pinetree Dr
City: Ft. Pierce State: FL
Address:
Zip Code: 34982 Fax:
City: State:
Phone No. 772-631-3595
Zip Code: Fax:
E-Mail: crosko341 @yahoo.com
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page (if different
State or County License:
from the Owner listed above)
It value of construction is S250U or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEE.R... •
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_ Not:Applicable MORTGAGE COMPANY:
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FEE SIMPLE TITLE HOLDER:
� Not Applicable
BONDING�COMPANY: "
� 'Not Applicable
Name:.:.....-
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Address:.....:
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City:
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OWNER/ CONTRACTOR AFFIDVIT:.Ajiplication: is hereby made to obtain. a permit to do the work:arid installation as indicated.
I certify -that no work or installation has commenced prior to -the issuance of a permit:
St:,Lucie Count�yy makes no representationthat is granting a permit will 'authoriie the,permit holder to-build'the subject structure
which is in,conflict-with ariy applicable Home Owners Association "rules; bylaws or and covenants.that may:restrict or prohibit such
structure. Please consult with.yourHome.Owners'Association and review your deed forany restrictions which may apply.
In consideration: of the granting of. this requested permit, I do hereby agree that l will; in all respects,:_perform the.work
in accordance with the approved plans; the Florida and�St. Lucie. County: Amendments.:
.
The following building permit applications are exempt from undergoing.a full concurrency review:.room additions;
accessorystructures, swimming pools; fences,'walls; signs, scre.en.rooms and:accessory uses.to:'an' her non-residential use
WARNING TO OWNER: -Yourfailure•to,Record a. Notice. of Commencement may result in your paying twice:for
improvements to your erty. A�Noti - of cominencement must: be recorded and posted. on the jobsite.,
before. thfe..first In coon. you intend to obtain:"financing, consult with lenderor an'attorney before
colnmencin :wo or� din y oue.Notice of�CoMmencement.:. .
ign `turof Owner/ Lessee/Contra ent for Owner: "' Signature of Contractor/License Holder
STATE OF FLORID
STATE OF FLORIDA
COUNTY OF-...:.. �._
-.n COUNTY OF ..
The,for oing instrurrient as acknowledged before me The forgoing instrument:was acknowledged before me -.
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Name"of person rrlakingstatement_ Name of.pecson making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification ' Type of Identification
,Produced Produced
.NOTARY PUBLIC
STATE OF FL0121
(Signature
t da (Signature'of Notary Public -State of Florida.)
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Commission No... :... . -(Seal)
Commission No..: • (Seal)
REVIEWS- FRONT . :ZONING :. SUPERVISOR. PLANS- VEGETATION SEA TURTLE _ MANGROVE
COUNTER REVIEW, REVIEW REVIEW � REVIEW :: ; . ''.REVIEW • RE1/IEW
DATE"
RECEIVED
"DATE- :. .. • ..
COMPLETED' ....
Rev: 8/2/17 .. „ ..