HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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:
PROPOSED IMPROVEMENT LOCATION:
Address: S. BROCKSMITH RD FORT PIERCE, FL 34945
Legal Description: 17-35-39 NE1/4 OF NE1/4.OF NW1/4 - LESS N 331.18 FT AND LESS CANAL RAN
Property Tax ID 4* 2317-21-1-0020-000-3 Lot No. N/A
Site Plan Name: WAUTERS MH INSTALLATION Block No. N/A
Project Name: WAUTERS MH INSTALLATION
Setbacks Front 234.6' Back: 358.5' Right Side: 144.0' Left Side: 111.1'
DETAILED DESCRIPTION OF WORK:
30.0' x 76.0' MOBIL(= HOME INSTALLATION
CONSTRUCTION INFORMATION:
itiona work to be performed under this permit — checkche6k all that apply:
•_ HVAC _ Gas Tank — Gas Piping _ Shutters _ Windows/Doors- -
:•: Electric Plumbing _ Sprinklers _ Generator _ Roof Roof pitch
Total Sq. Ft of Construction: 2255- . !• Sq. Ft. of First Floor: 2255 --
Cost of Construction: $ 22,000.00 Utilities: —Sewer ` . Septic Building Height: 15.0'
OWNER/LESSEE:
CONTRACTOR:
Name DANIEL^,WAUTERS , l' -'::.,
Name:
KURTALLE:'W
Address: 1115S; BR`OCKSMITW' Rq,!°:
Company:
KURT ALLEN ,
City: FT: PIERCE,.;,,; ,:, State: FL
Address:
56.0,3:IKE;SMLTH RD
Zip Code: 34945 Fax:
City:
PLANT CITY State: FL
Phone No. 772.284.2515
Zip Code:
Phone No.
33565 Fax: 813.717.9842
813.717.9841
E-Mail: MYBOYDAVIN-16@GMAIL.COM
Fill in fee simple Title Holder on next page (if different
E-Mail:
ALLFLPERMITTING@AOL.COM
from the Owner listed above)
State or County License: IH1025140
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
ENTAL CONSTRUCTION LIEN LAW INFORMATION:
_ Not App
Name: _
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name: _
Address:
City: city:
Zip: Phone: I 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 your Notice of Commencement.
Signature of Owner/L ssee/ on ractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
�4-
The for om instry�men was acknowled d before me
this day of _c1 20by
4, - 61AU,
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known L/611 Produced Identification
Type of IdentificationX,%duced
KITINA A BLOOM
Commission No. * *MYCOMMISSION(kfg71106
c�EXPIRES: Febfuary25, 2021
of AY Bonded Thm Budoet NataN.o..,.c
Revised 07/15/2014
s
Signature of Con /L' of er
STATE OF FLORIDA l
COUNTY OF
The fort oirainstru ent was acknowledged before me
this =day of A 20 U_ by
(Name of person acknowledging)
(sign atur o Notary Public- State of Florida )
Personally Known 0---OR Produced Identification
Type of Identification Produced
o�o`Y?rev KITINA A BLOOM
Commission N0. ° MMWION#000�W l)
a. pe EXPIRES:Fdug25,2021
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW'
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
L
INITIALS
19
Date:
CABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number: 1 I L) 0 " �O
.1. `/4uno0 along 'IS
Building Permit Application 80z Z A SIP
Planning and Development Services
Building and Code Regulation Division o B
2300 Virginia Avenue, Fort Pierce FL 34982 e I � v� ° d
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION'
Address: S. BROCKSMITH RD FORT PIERCE, FL 34945 Qd
Legal Description: 17-35-39 NE1/4 OF NE1/4 OF NW1/4 - LESS N 331.18 FT AND LESS CANAL R/W 1
Property Tax ID #: 2317-211-0020-000-3 Lot No. N/A
Site Plan Name: WAUTERS MH INSTALLATION Block No. N/A
Project Name: WAUTERS MH INSTALLATION
Setbacks Front 234.6' Back: 358.5' Right Side: 144.0' LeftSide: 111.1'
DETAILED DESCRIPTION OF WORK:
0' x 76.0' MOBILE HOME INSTALLATION
Q
21M k
_I \
CONSTRUCTION INFORMATION:
Additionalwork to be performed under this permit —check all that apply:
O HVAC _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors
M. Electric RR Plumbing _ Sprinklers _ Generator _ Roof Roof pitch
Total Sq. Ft of Construction: 2255
Cost of Construction: $ 22,000.00
Sq. Ft. of First Floor: 2255
Utilities: —Sewer aseptic
Building Height: 15.0'
OWNER/LESSEE:
CONTRACTOR:
Name DANIEL WAUTERS
Name:
KURT ALLEN
Company:
KURT ALLEN
Address: 1115 S. BROCKSMITH RD
City: FT PIERCE State: FL
Address:
5603 IKE SMITH RD
Zip Code: 34945 Fax:
City:
PLANT CITY State: FL
Phone No. 772.284.2515
Zip Code:
33565 Fax: 813.717.9842
E-Mail: MYBOYDAVIN-16@GMAIL.COM
Phone No.
813.717.9841
Fill in fee simple Title Holder on next page ( if different
E-Mail:
ALLFLPERMITTING a(�AOL.COM
from the Owner listed above)
State or County License: IH1025140
IIIf value of construction is $2500 or more, a RECORDED Notice of Commencement is required. II