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Home My WebLink AboutBUILDING PERMIT APPLICATIONALL APPLICA LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED \ p Date: �') 1 ` Permit Number: �. _ I. �CANNr�'' FREIVED • �` Q='1�nIS r?b0rj.� i"ab7 . ---- - Building Permit Applicatio1,Planning and Development Services unty, Permitting Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 �% Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential t PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line 6 61 5 '0t' A - tPROPOSMIMPR,OVEMENT LOCATIO :' Address: c9- mornCAOLna CLoLiJ- -4- Legal Descri PropertyTax ID #: COO c) _ Lot No. Site Plan Name e 1 I Block No. I Project Name: (� Setbacks Front Back: I Right Side: Left Side: I _ "DET-AILED' DESCRIPTION+.OF, WORK: I �n�al i aso UP �Crcl's 40-n t-+-o xata� -ON'TRU:CTI"O'N��IWORMATION: � Additionalworktobepertormedun er t is 'lermit—check E1HVAC ❑Gas Piping all apply: Shutters ❑Windows/Doors ,Gas Tank _ Electric Plumbing []Sprinklers Generator Roof Roof pitch Total Sq. Ft of Construction: `a.\ S . Ft. of First Floor: 0Septic Height: Cost of Construction: $ S • a a Utilities:lnSewer Building ,'OV1/NER/LESSEE: ' CONTRA(T©R: - - - - - - - - - - - - - - --Blake mI tiv Nae Addre a- Name: Cowdell Company: Energized Gas City: S Zip Code 5 Fax _ — Phone No- E-Mail• ..., 'te''. nn, L, "l�l�Q� w' ^4 Address: 4252 Bandy Blvd. ity: Fort Pierce State: FL ip C e: 34981 Fax: 772-318-6672 one No. 772-466-1095" E-Mail; Fill in fee simple Title Holder on next page ( if from the Owner listed above) ifferent State or County License: If value of construction is $2500 or more, a RECORDED Notice of Commencement is requirea. 1019 `SUPPLEMENTAL CQNSTRUCTI'QN� LIENi!LAVU L:NFOR_IVh4�',I ON: J DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Blake Cowdell Address: Address: City: State: City: FortPleme State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: 4252 Bandy Blvd. Address: City: City: Zip: Phone: Zip: 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 commencing work or recording our Notice of -Commencement. �G�-CQP Signature of Owner/ Lessee/Contractor as Agent -for Owner Signature of Contractor/License Holder, STATE OF FLORID LLLIp _eSTATE OF OF FLOR /) (JCOUNTY COUNTY OF - ( S " b ' ) The forg nstru nt was cknowledg efore me 1 this��f 20by -CL a c The f o r►�i trum nt a knowledg efore me this y o 20 by 0, A V� ALI1 Name of pe o making statement Name of p making statement Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identificatio I Produced Vv r Type of Identificati n I 9 Produced L lL, ov/ n L c (Si F ature of Notary Public- State of Florida) (iignaiurL of Notary Pub�ir,�&tpl� f Florida ) ��ii \\0 ��FER'•CO Commission No. Wnliilu�i Seal i, (Seal) Com Sion No. ��`i, lsn s�gti 9 % (Seal) 10, p y m. REVIEWS 4:aa T ® _lk SUPERVISOR PLANS VEG-S,TA' N U IS�AT,Vi 4 MANGROVE (UfVTEPt U lR/IE1A/ REVIEW REVIEW RE M # G �/ EVIL REVIEW DATE RECEIVED '.,.,�sjq??M. # G OF O\'1 ��\\\\,• DATE COMPLETED �iiiFlFt �� Rev. 8/2/17