HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
ALL APPLICABLE INFO M
Permit Number:
Date: C 6 / 7
RECEITas �N 1c1
Building Permit Application
_— ---_--
Planning and Developmen
Services
Building and Code Regulation
Division
2300 Virginia Avenue, Fort
Pierce FL 34982
Commercial Residential
Phone: (772) 462-1553
Fax: (772) 462-1578
PERMIT APPLICATION
FOR: To Select from dropbox, click arrow at the end of line Rdd
PROPOSED IMPROV
MENT LO:CATIO:N
Address: oi.
Luc-'( J R p < c <
Legal Description:
c
Property Tax ID #: 14
33 -^ a - 023 b-da Lot No. 36"1
Site Plan Name:
Block No.
Project Name:
Setbacks Front
Back: Right Side: Left Side:
DAILED DES,.CRIPT
ET
ON DF WORK:
I�CCove-C iold
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[CON�TRUCTION-IN:=ORMATION
i
.
Additional wor to e e
�_
_.
orme un er t is permit - c ec a app y:
❑Gas Shutters ❑ Windows/Doors
❑HVAC
as Tank Piping _
❑Electric ❑Plumbing
Sprinklers a Generator Roof
Total Sq. Ft of Construction:
1870 S Ft. of First Floor:
O Building Height:
Cost of Construction: $
l O Utilities: Sewer Septic
OWNER%LESSEE:
CONTRACTOR:
Name v.�
ec
Name: Rebecca J. Mays
� �s�� vc�
Address: a �
Company: Comfort Cover Systems, Inc.
State: FL
Address: 711 Tumer Street
City: Clearwater State: FL
City: -
Zip Code:
Fax: '�'
Zip Code: 33756 Fax: 727-298-0111
Phone No. -
S
Phone No. 727-298-0955
E-Mail: Info@ComfortCover.org
E-Mail:
Fill in fee simple Title Ho
der on next page (if different
from the Owner listed a
ove)
State or County License: CCO057091
If value of construction is $
500 or more, a RECORDED Notice of Commencement is required.
SL1rIp:PLEMENTAI
GO.
_ - :....
STR,UCTION LIEN` LAV1l' INFORMATION:,
DESIGNER/ENGINEER:
Name: Thomas Dixon
Address:1o4lo Main street
City: Thonotosassa
Zip: 3M2 Phon
_ Not Applicable
MORTGAGE COMPANY: _y_ Not Applicable
Name:
Address:
State: FL
: 727-524-1905
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phon
- Not Applicable
BONDING COMPANY: Y 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 rE presentation 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 wft 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 perm 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 roperty. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspecti n. If you intend to obtain financing, consult with lender or an attorney before
commencing work or rE cording our Notice of Commencement.
Signature §f Owner/
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this A day of 20 11 by
(Name of person acknowle ing )
(- I nat re of Notafv Publicl State of Florida )
Personally Known V
Type of Identification Pi
Commission No.
Revised 07/15
R Produced Identification
Signature 0 Contractor License Holder
STATE OF FLORIDA
COUNTY OF P, ,,((,-s
The forgoing instrument was acknowledged before me
this �) day of ;Tvo-e , 20_ff by
P
(Name of person acknowledging)
(Signat re of No16 6 Pu ic- State of Florida )
Personally Known ✓ OR Produced Identification
Type of Identification Produced _ _ _ . A .64ft .
of Florida Commission No.
Anne Meade
My Commission FF 060118
Expires 11/04/2017
(�ggta Public state of Florida
sn��Meade
My Commission FF 060118
Fxoires 11104/2017
FRONT
COUNTEI
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
REVIEWS
DATE
COMPLETE
INITIALS