HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 08/04/2017 Permit Number: /-
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Building Permit Application Q ��
Planning and Development Services v�
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: Mobile home , FAN flees 1
PROPOSED IMPROUEMENT'LOCATIO.N
Address: 15090 Aguila Fort Pierce, FI. 34951
Legal Description:
Property Tax ID #:
Site Plan Name:
Project Name: Kehs remodel
Setbacks Front Back
See attached scope of work.
Right Side: Left Side:
n':W(_ 140C-N . gz Pp"'A-enahl
Lot No._
Block No.
CONSTRUCTION INFORMATION
.
Additiona wor;-to." e e
er orme under" permit—
�this permit — check
jHVAC
a
apply:
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LJ
Gas Tank
Gas Piping
_
Shutters
Windows/Doors
Electric 0
Plumbing
Sprinklers
ElGenerator
Roof Roof pitch
Total Sq. Ft of Construction: 400
of First Floor:
SIn
Cost of Construction: $ 12,000.00
Utilities:Sewer
OSeptic
Building Height:
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OWNER/LESSEE
CONTRACTOR
Name John P Kehs Sr.
Name: David Ottaviani
Address: 15090 Aguila
Company: JASD Sales and Marketing Inc
City: Fort Pierce State: Fl
Zip Code: 34951 Fax:
Phone No. 772-579-9391
Address: PO Box 2042
City: Jensen Beach State: Fi
Zip Code: 34958 Fax: 772-679-0194
Phone No. 772-334-8374
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: info@jasdinc.com
State or County License: CGC1512947
If value of construction is $2500 or more, a RECORDED Notice of Commencement is regmreu.
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:'
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: — Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:. Not Applicable
Name:
-Address:--
City:
Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit, to do the work and installation as indicated.
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
commencine work or recordine vour Notice of Commencement.
QW,
Lice Ider
Signature of Owner/ Lessee ontractor as Agent for Owner
Signature o ractor
STATE OF FLORIDA .
���
STATE OF FLORIDA LCOUNTY
OF
COUNTY OF u /I
The forgoing instr ment was acknowledg d efore me
this � day of 20 by
The f r oing instrum t was acknowledged before me
this :, day of 20_ by
(Name of person acknowledging)
(Signature of Not ry Public- State of Florida)
(Name of person acknowledging)
-(Signature of N ryPubli�c- State of Florida )
Personal( o q, Og OMdatkWflllentifi tiori
Personally Known �l� OR Produced Identification
Type of I ' Y P N y ublic - state of Florlda
Produced` 2a P isan # FF 234130
'
Type of Identifi ation
Proc!Qed-- °
N, `0 My Comm. Expires -Wa-y 27, 20i9
COmmISs n 1�1Vnn,� Bonded through National ar Assn
oSPRY PGe ANGELA M HUFF
CommiSs Y ► ublic - IIS I)
ate of I orl
Commission
` # FF 234730
oovIoa My Comm. Expires
r
IUVU Inrotigh
National Notary Assn. -
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATI
l • .
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
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RECEIVED
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DATE
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COMPLETED
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Rev. 7/ZU14 snwcava&
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All APPLICABLE INFO MUST BE cow °rED FORIA
Date:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort -Pierce FL34982- - --
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: {
Address:
Legal Description:
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks Front Back:
Aaditionai worK to ne.perrormea, unaer finis pei
_Mechanical _ Gas Tank r _
_ Electric _ Plumbing _
Total Sq. Ft of Construction:
Cost of Construction: $
Name
City:
Zip Code: Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page (if
from the Owner listed above)
TION TO BE ACCEPTED
Permit Number:
ilding Permit Application
Commercial Residential
ht Side: Left Side:
U ICLK tlll UICIL CIJ'.JIY.
Piping _Shutters
inklers Generator
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic
Lot No.
Block No.
_Windows/Doors
Roof Pitch
Building Height:
Name:
Company:
Address:
City: State:
Zip Code: Fax:
Phone No
rent E-Mail
State or County License
If value of construction is 2500 or more, a RECORDEDINotice of.Commencement is required.