HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI alp
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7/9/18 Permit Number:
tt� 11
SC N O
�f I^
! Building Permi Application
RECEIVED .
JUL 1 2 018
Planning and Development Services
Permitting Dee
I�
Building and Code Regulation Division
partrt ment
St Lucre County
2300 Virginia Avenue, Fort Pierce FL 34982
` Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
`; PROPOSED` IMPROVEMENT, LO,CATIO'N:
Address: 1526 NW ButtonBush Cir, Palm City, FL 34990
Legal Description: Harbour Ridge Plat 13 ButtonBush Village Unit 63 (or 3328-1609 thru 1611)
roperty Tax ID #: 4426.815-0070-000-3
Lot No.
ite Plan Name: Fraser Residence A/C
Block No.
roject Name: Fraser Residence A/C
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
J,n S+a i10 H -T&l )toSEC 2 `VCkjsd Sq 1;+uD 161%41 1vf-wnW-o-T
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CONSTRUCTION INFORMATION: .
dditional work to je nej orme un er t is permit — check a apply:
CJHVAC I_J Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors
❑ Electric ❑ Plumbing ❑ Sprinklers ❑ Generator ❑ Roof Roof pitch
I Sq. Ft of Construction:
of Construction: $ 1315-1:1 . b(�)
Sq. Ft. of First Floor: _
Utilities: 0 Sewer ❑ Septic
Building Height:
pVVNER[LESS'EE:
C RACTOR:°
,,hone
!fill
ame Brent & Lois Fraser
Name:
Company: M
Address: IIIiQ SE r .m
City: LA 6 (? State:
Zip Code: �?� Fax: W _61(� 3 I to
Phone No. 1 C'
E-Mail: um
ddress:1526 NW ButtonBush Cir
ity: Palm City State: FL
ip Code: 34990 Fax:
No. 513-703-0196
-Mail: 772-204-2711 / 513-374-2090
in fee simple Title Holder on next page (if different
om the Owner listed above)
State or County License: ! ec ba�ABa
value of construction is 52500 or more, a RECORDED Notice of Commencement is requires.
SUPPLEMENTAL CONSTRUCTION LIEN 'LAW;INFORMATION:
DESIGNER/ENGINEER: x Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: State:
City. State:
Zip: Phone
Zip: Phone:
dixFEE
SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
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
commencine work or recordine vour Notice of Commencement.
,
Signature o wner/ Le see/Contractor as Agent for Owner
Signa ure of Contractor/License Holder
STATE OF FLORIQ
7 l
STATE OF FLOR(� ,
�C
COUNTY OF vU,
COUNTY OF Jk . 2.
The forgoing instrument was acknowledgebefore me
this n day of 20 by
The foSoing instrument was acknowledged before me
this La day of SQ l 2618 by
Ak
ip
Name of rs n making statement
Name of pers making statement
rsonally Known OR Produced Identification
Personally Known OR Produced Identification
pe of Id iftcation
oduced �� �(� l '
Type of Iden�ti ' ,a,ti�`on
Produced_ I I �C]�'iCS 1� l 11"� LL
(`,
$
o
'gnature of N ry Public- State of Florida)
(Signature of Nota ftbliccS�tate of Florida )
�(
r mission No. C % (Seal)
Commission No. t o% (Seal)
d
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REV)EW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
%
DATE
COMPLETED
8/2/17