HomeMy WebLinkAboutBUILDING PERMIT ASPPLICATIONi
ALL APPLICABLE INFO MUST BE QOMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit FU
NED
BY
f �.0 io 0
Building Permit Applicat on MAY 0 7 201
Planning and Development Services, Department
Building and Code Regulation Division permitting Dep ' �L
2300 Virginia Avenue, Fort Pierce FL ,34982 t Lucie County
Phone: (772) 462-1553 Fax: (77Z) 462-1578 Commercial
PERMIT APPLICATION FORM To Select from dropbox, click arrow at the end of line
Address: 1 ZU5 Bennett Ko
Legal Description13 35 39 N 2
AND E 115 F
Property Tax ID #: 2313-124-1
Site Plan Name:
Project Name: Conant Whi
Setbacks Front • Ba
rt Pierce. FL
IFTOFE1/2OFSE1/4OFNW1/4OFNE1/4-LESSE30FT
OFN2ACOFS5ACOFW1/2OFE1/20FNW1/4OFNE1/4
I
01-000-5 1 Lot No.
11. Block No.
Ri6t Side: Left Side:
a- .zA X�G✓ 64-c E7ft✓",9 iZ/<
E1HVAC LJ Gas Tank
Electric ❑ Plumbing
ALL APPLICABLE INFO MUST BE QOMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit FU
NED
BY
f �.0 io 0
Building Permit Applicat on MAY 0 7 201
Planning and Development Services, Department
Building and Code Regulation Division permitting Dep ' �L
2300 Virginia Avenue, Fort Pierce FL ,34982 t Lucie County
Phone: (772) 462-1553 Fax: (77Z) 462-1578 Commercial
PERMIT APPLICATION FORM To Select from dropbox, click arrow at the end of line
Address: 1 ZU5 Bennett Ko
Legal Description13 35 39 N 2
AND E 115 F
Property Tax ID #: 2313-124-1
Site Plan Name:
Project Name: Conant Whi
Setbacks Front • Ba
rt Pierce. FL
IFTOFE1/2OFSE1/4OFNW1/4OFNE1/4-LESSE30FT
OFN2ACOFS5ACOFW1/2OFE1/20FNW1/4OFNE1/4
I
01-000-5 1 Lot No.
11. Block No.
Ri6t Side: Left Side:
a- .zA X�G✓ 64-c E7ft✓",9 iZ/<
E1HVAC LJ Gas Tank
Electric ❑ Plumbing
E]Gas Pi
[:]Sprinl
Total Sq. Ft of Construction:
I
Cost of Construction: $ 1500
I
ing L_I Shutters
2rs FK] Generator
S Ft. of First Floor: _
Utilities: Sewer Septic
aWindows/Doors
Roof Roof pitch
Building Height:
NameJx/7?- 0W 1 42VAIA.^/ 7'
Name:
Address: JafS a.5A1^1, 77_ 2®
Company:
City: g-r State: (2 L
Address:
City: State:
Zip Code: Fax:
Phone No. 7z •260 _C
Zip Code: Fax:
Phone No.
_I
E-Mail: W141%A e—e-r doc& rS7 Ae
Fill in fee simple Title Holder on next, page ( if different
E-Mail:
State or County License:
:from the Owner listed above) 1
IIf value of construction is $2500 or morel a RECORDED Notice of Commencement is required. I
S
SOP P`L`E(VIENTALCONSTRUCTlON LIEN SAW INFORMATION: =4
NER ENGINEER: Not Applicable
DESIGNER/ENGINEER: Pp /
MORTGAGE COMPANY: _ Not Applicable
Nam
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone I
� I
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: _Not Applicable
Name: I
Name:
Address:
Address: I
City:
City: I I
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT:i 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'ithat is granting a;permit will authorize the permit holder to build the subject structure
is in Home Owners bylaws
which conflict with any applicable Association rules, 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
ommencing work or recording our, Notice of Commencement.
'
•j:
F
� I
S gnature of Owner/ Lessee/Contractor as Agent for Owner `
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF LUZ,J ,C
COUNTY OF
The for ing instrument was acknowledgedlbefore me
The forgoing instrument was acknowledged before me
this day of MI%4 , 20_/& by
this day of 20_ by
Name of p Arson making statement
Name of person making statement
Personally Known OR Produced Identification of
Personally Known OR Produced Identification
Type of Identification TT /
Type of Identification
Produced V L
Produced
(Signature of Notary Public- St of Florida)
(Signature of Notary Public- State of Florida )
Commission No.
Commission No. (Seal)
N".3,
REVIEWS FRONT ZONIN PE ISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER REVIE 6Tn' W
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
m
o-o
-• o
DATE
m30°:M
COMPLETED
-c
? n7D
Rev. 8/2/17
M 0 G) C
oz
o IT —nn
N- W
_. G,-_
MAY 0 7 2018
0 N C M
Permitting
Department
St. Lucie County, FL