HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED F
Date-
BUildi
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce F134982
Phone: (772) 462-1553 Fax: (772) 462-1578
TO BE ACCEPTED �Q 2
Permit Number:
Permit Application
810? 6 I NM
Commercial Residential xx
PERMIT APPLICATION FOR: To Selec from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 114 Queen Bess Court, Fort Pierce, FI 34949
Legal Description: Lot E, Block 23, Queens Cove -Unit two, Plat Book 20
Property Tax ID #: 1414-702-0023-000-6 11
Site Plan Name: lyog-wW A �sr'i
Project Name: & Att i I -
Setbacks Front Back: Right Side: Left Side:
I
DETAILED Df~SCRIPTION OI` WORK:
CONSTRUCTION INFORMATION:
0HVAC U Gas.Tank . !j
0- Electric 0 Plumbing L
Total Sq. Ft of Construction: �,99 L F
Cost of Construction: $
2O"
OWNER/LESSEE:
Namd Eiodle Bacc i
Address: 5310 Valencia Ln SW
City: Vero Beach `
Zip Code: 32968 Fax:
Phone No 630 726 2176
E-Mail: gibacci@gmaii.com
Fill in fee simple Title Holder on next page ( If
from the Owner listed above)
if value of construction is $25g0 or more, a
Lot No.
Block No.
1R— �ne�R an aMNY
Piping _Shutters Windows/Doors
nklers Generator Roof Roof pitch
S . Ft. of First Floor:
Utilities: 0 Sewer OSeptic Building Height:
CONTRACTOR: a���
Name•, (Vl2[��ta �6,A,
Company:
e.FL Address: 2 i 0 Gaeta LO'NL2
City. \f @may Stater
Zip Code: eL% D Fax:
_ Phone No.
Ferent E-Mail:
State or county License: CGL [ 5 c
Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN
I
LAW INl=ORMATION:
DESIGNER/ENGINEER: Not Applicable
Name: KY11!5 i T M , % JlCacrti
Address: b�
City: ll�ei State:
Zip: GIZ(n o Phone '7172-VA 5oi�o
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
�
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: I
Address:
City: I
Zip: Phone:
I
BONDING COMPANY: Not Applicable
Name:
Address-
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Applicatign 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, wallsf 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,+vork or recording your Notice of Commencement.
Signature of OVher/ Lessee/Contractor as Agent
STATE (IF FL
COUNTY OF
The forgoing instrument was acknowledged befs
this L day of /elf &2 ff . 2OZ by
Name of person making statement
Personally Known OR Produced Idi
Type of IdgAlfication
Commission No.
REVIEWS I FRONT 1 ZONING
COUNTER REVIEW
COMPLETED
Rev. 8/2/17
r Owner Signatur of Contractor/ ' eFse Holder
STATE OF FLORIDA
COUNTY OF T&;�4,, ,,,r-
me The forgoing instrument was acknowledged before me
this L day of/14gg / , 20/,_*--" by
/ Name of person%raking statement
ion V Personally Known V OR Produced Identification
Type of identification
Produced
(Si re of Notary P a
i
236890� .
2019 Commission No._.'� = commis n#11��F236il90
. eo 'ems q Expires '29, 2019
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ANGROVE
REVIEWOR I REVVIIEJA I vREVIEWON 1 S REVIEW `AREVIEW