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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 08/03/2017 Permit Number:
RE C E I':.: u AUei � � •�aiaf
Building Permit Application
Planning and Development Services
Building and Code Regulation Division C 'Qr-\
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Building
PROPOSED IMPROVEMENTLOCATION:
Address: 7508 Coquina Avenue V t'Rf u
Legal Description: Lakewood Park - Unit 7 - Block 79 - Lot 5
Property Tax ID #: 1301-607-0226-000-0 Lot No. 5
Site Plan Name: Habitat for Humanity Lot 5 Block 70 Lakewood Park Unit No. 7 Block No. 79
Project Name: 7508 Coquina 55-ww 2(j, id' .14,31"
Setbacks Front 30.00 Back: �8- Right Side: -G'TO Left Side: _aA)0__
DETAILED DESCRIPTIO 01 WORK:
New construction of a VBR, 2 Bath, CBS single family residence. I 0-,AR GMT A6r--
CONSTRUCTIONINFORMATION:
Add itiona I work to be Performed under tisPermit—check all that apply:
ZHVAC Li Gas Tank
Electric 0 Plumbing
Total Sq. Ft of Construction"
Cost of Construction: $ 150,000
Piping Z Shutters Q Windows/Doors
nklers 0 Generator Roof 4�12 Roof pitch
S . Ft. of First Floor: 1,201 15L/ L/
Utilities: 11 Sewer 7 Septic Building Height: 8.00
OW N E RAESSEE:
CONTRACTOR:
Name St. Lucie Habitat for Humanity, Inc.
Name: Joseph Gianna
Address: 702 South 6th Street
Company: St. Lucie Habitat for Humanity, Inc.
City.. Fort Pierce State: FL.
Address: 702 South 6th Street
Zip Code: 34950 Fax. 772-464-4377
City: Fort Pierce State: FL
Phone No. 772-464-1117
Zip Code: 34950 Fax: 772-464-4377
E-Mail: Joseph@stiuciehabitat.org
Phone No. 772-464-1117�,
Fill in fee simple Title Holder on next page (if different
E-Mail: Joseph@stluciehabitat.org
from the Owner listed above)
State or County License: Florida Statute 489.103
If value of construction is $2500 or more, a RECORDED Notice of Commencement is requirea.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable
Name:
Address:
MORTGAGE COMPANY: x Not Applicable
Name:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: x Not Applicable
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. 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
commencinia work or recording vour Notice of Commencement. n
Cignatur�jEif Own`e6Lesse actor as Agent for Owner
STATE
((//OF FLORIDA
COUNTY OF St. Lucie
The forgoing instrurpent was acknowledged before me
this _ day of 20 !Zby
Donna Weather4on
(Name of person acknowledgin
/_7
ature of Notary Public- Stke of Florida )
Personally Known x
Type of Identification
Commission No. FF3701
Revised 07/15/2014
DONNA WEATHERINGTON
Notary Public - State of Florida
My(Gw Exp•res Aug 20, 201i
Commission # FF 37018
tense H
STATE OF FLORIDA
COUNTY OF St. Lucie
The fo oing instrument was acknowledged before me
this day of Awablf7 , 20 /_7 by
Donna Weatherington
acknowledging)
Notary Public- State
nally Known x
of Identification
s. V I.-_S Notary Public - State of Florida
mISSIOn NO. FF 37018 ;N„ • My CfMl]:xpires Aug 20, 2017
%. OFi10µW` Commission # FF 37018
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