HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNEZ Permit Number:
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Building Permit Applicatio
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
.1 d-a- da13
RECEIVED
FEB 0 9 2018
ST. Lucie County,
Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address: 1-10 i n 35J."`' 5* For} Pierce; �7_Z.. 3L1gg7
Legal Description: Su.nka id Go rdenS iM 14 L06 3, 44 5 CO. P SAC, (09 309,A-
PropertyTaxlD#: o2q05'—(001- 0a51-000-5 LotNoAq, 5
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
Sol.Afz Ho-T U)ATE2 y 15A-r,n9 5)54-em
Iditional work to be
0HVAC
nPrrormed
Gas Tank
under tnis permit — cneck au
❑Gas Piping
apply:
Shutters
Windows/Doors
_
Electric
❑✓
Plumbing
[]Sprinklers
F-1
Generator
E]
Roof
Total Sq. Ft of Construction:
Cost of Construction: $ t.S00. e .
S Ft. offl t Floor: _
Utilities: Sewer 0 Septic
Building Height:
M a k it T'� ,�"
OWNER%LESS'EE rt
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Name 9'o rl Gcv-aver
Name: RobertZrallack
Address: 1-101 in 3gw
Company: Solar Energy Systems
City: FO<A State: F(—
Zip Code: 3NGy7 Fax:
Phone No. ,1a' � e1- 55a-7
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Address: 160 Smallwood Avenue
City: Fort Pierce State: FI
Zip Code: 34982 Fax: 772-466-7937
Phone No. 772-464-2663
E-Mail: vpsolarenergy@yahoo.com
State or County License: CVC056637 / 9057
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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SUPPaMEaNTAL COfVS�TR-UCf�Ij®N.L6E�I�LA�1N IN.F®RNI�ATI®N��' �, � ��-�
DESIGNER/ENGINEER: Not Applicable
Name:
Address:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
City: State:
Zip:' Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
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 Comm
_ Signature of Owne ssee/Agent
STATE OF FLORIDA
COUNTY OF
The fo Ing instrument was acknowledged before me
this F day of C4 bruoar„ 20 IFS by
Robert Zrallck 1
nt.
i� s
Signature of Contra /License Holder
STATE OF FLORIDA
COUNTY OF.
The forgoing instrument was acknowledged before me
this 1 day of 20 $ by
Robert Zrallack
(Name of person acknowledging) I (Name of person acknowledging)
///ai:ij - gZ, 7%%,.Oe4
(Si nature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida )
Personally Known ✓ OR Produced Identification
Type of Identification Produced t88�0
Commission No. FF9I21.37 a NOTARY PUBLIC
STATE OF FLORI'.
Comm# FF912137
Revised 07/15/2014
Personally Known OR Produced Identification
Type of Identification Produced
ission No.fED2437 TARYPUBLIC
ATE OF FLORIDA
. Comm# FF912137
Expires 8/24/2019
REVIEWS
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DATE
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INITIALS