HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / F� O-� 1 /�}
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Building Permit Application JUL 2 5 2018
III
Plaiilning and Development Services Pei (i l loin Del
Department
BDing and Code Regulation Division
FL34982 �t� �-���e ��untyo FL
230�IVirginia Avenue, Fort Pierce
Ph I e: (772) 462-1553 Fax: (772) 462-1578 Commercial Resi en Ia
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
P,OSED� IMPROVEMENT LOCATION: ' <
.PRO _
Addrl11 7305 FORT WALTON AVE FORT PIERCE FL. 34951
ess:
67 LOTS17 AND18
LAKEWOOD PARK UNIT 6-BLK
LegaDescription:
1 1301-606-0186-000-4 Lot No.17/18
Tax ID #:
57
PropeFain
Site P Name: WILLIAM DUPUIS Block No.
Name: SAME
Pro)egt
Setballcks Front Back: Right Side: Left Side:
DETAILED DE SCRIPTION.OF WORK:..
SHIN LE TO 5 V-METAL AND REPLACE FLAT
TRUCTION INFORMATION:
CONS`
Additional
Llwor to e e orme un er t is permit— c ec a app y:
❑_ HVAC Gas Tank ❑Gas Piping _ Shutters Q Windows/Doors
5 12 Roof pitch
Illectric Rj
Plumbing Sprinklers Generator Roof
Total ,S Ii. Ft of Construction: 2400 S . Ft. of First Floor:
11,000.00 11 Height:
1onstruction:
Cost ofl $ utilities.. Septic Building
;OWN ,,R/LESSEE: .,
CONTRACTOR.:
ame I�
Name:
ddres !. 7305
IA'
Company:
FState:
ii
AddrFOity:
Zip Co �I : Fax:
City: State:
4951 -468-0=
- -
Phone o.
Zip Code: Fax:
E-Mail:
772-468-0202
Phone N.
E-Mail: jgcannonroo Ic ou .com
Fill in fete simple Title Holder on next page if different
State or County License: CCC
from the' Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
II
DESIGNE
11
Nlne:_
Address:
N
Ciy
Zi :
ENTAL CO(VSTRUCTION LIfN LAW INFORMATION:
ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
State: City:.
Ph ne•
State:
Phone Zip: °
SIMPLE TITLE HOLDER: — Not Applicable BONDING COMPANY: —Not Applicable
re
Name:
Address:
City:
Phnne: Zip: Phone:
O NER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I ter ify that no work or installation has commenced prior to the issuance of a permit.
St. tie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
strut ure. conflict
lease consult withpyolur Home Owners Association land reviewyyour deed foraven any restrictions which rmaor
apply obit such
Inc nsideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in a °cordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
Thee, allowing building permit applications are exempt from undergoing a full concurrency review: room additions,
acc ssory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
W �RNING 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
bef re the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
er
'ATE OF FLORIDA
)UNTY OF `
as
e f r Ding irist nt was acknowledge efoI
is�rday of 20byC3
Name of perso -making statement
!rsonally Known OR Produced Identifir!
rpe of Identification : v
-oduced Vt.,
.;o
iature of Notaryoblic- State of Florida )
mission No. (Seal)
REVIEWS FRONT ZONING
COUNTER REVIEW
iATE
DMPLETED
. 8/2/17
re of Cont c or icense Holder
�m
OF FLORIDA �
_ U-
C. LL
TY OF going instr en was acknowledge efore
F
o o��oday
of 20by
CL 1-1
Q c:X
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m
Name of . n making statement
Personally KnoaGn OR Produced Identificatio
Type of Identification
Produced
�1
(Signature of Nota Public- State of Florida )
Commission No. (Seal)
SUPERVIS
ANGRO
REVIEWOR I REVIEW I PLANSV REVIEW EGETATION I SEA TURTEV EWLE M EVIEWVE