HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONFA
APLICABLE INFO MU'ST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
te{ e ' /f r Permit Number:
RECEIVED
—I Building Permit Application
PlanrJing and Development Services O C T `2 6 2018
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 ST. Lucie County, Per°mlttin�
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residentla -
PERI�IIIIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION;: SCANNED
Address: 8208 HIBISCUS RD, FT PIERCE, FL 34951
180f-hele County
Legal Description. LAKEWOOD PARK UNIT 5-BLK 53 LOT10 (MAP 13/02S)(OR 1885-572)
Site
V Tax ID #: 1301-605-0302-000-1
i Name: RUTLAND
Name: RUTLAND
cs Front Back:
DETAILED DESCRIPTION OFWORK:
Right Side. `'Left Side
Lot No.10
Block No. 53
CONSTRUCTION INFORMATIO'N
itrktobenerformed under t—checkispermit a apply:
11 VAC Gas Tank ❑Gas Piping fn _ Shutters Windows/Doors
0 Electric 0 Plumbing ❑ Sprinklers F Generator 11 Roof Roof pitch
Total Iq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction: $ oUtilities:Sewer Septic Building Height:
I
OWN ER/LESSEE:
CONTRACTOR:
NameWILLIAM RUTLAND
Name: JON LEVASSEUR
Addre1 8208 HIBISCUS RD
Company: DCS GUTTERS
City: FT PIERCE State•FL
Address: 2152 SE FERN PARK DR
Zip Code. 34951 Fax:
City: PORT ST LUCIE State: FL
Phone No.
Zip Code: 34952 Fax:
E-Mail:
Phone No. 772-216-6171
Fill in fee simple Title Holder on next page ( if different
E-Mail: Eden68@aol.com
from he Owner listed above)
State or County License: CBC 4282301
If value of construction is'$2500 or more, a RECORDED Notice of Commencement is required.
i
SUPPLEMENTAL CONSTRUCTION LIEN LAW -INFORMATION:
DESIGNER/ENGINEER: X Not Applicable *MORTGAGE COMPANY: X Not Applicable
Namie:�111111111111 11 I'D Name:fmm��
Address. Address:
City: aillwii State: City: williiff9d" fi State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X 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
structu. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In cons'deration 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.
6n'V,,-
C�''
LJ''
Si ature
of Owner/ Lessee/Contractor as Agent for Owner
Si nature of Contractor/License Holder
STATE
OF FLORIDA
STATE OF FLORIDA
COUNTY
OF
COUNTY OF �..�- - Loci �-
The forgoing
this
instrument was acknowledged before me
5day of �e�l c� 1' , 20-L by
The forgoing instrume t was acknowledged before me
this day of 201 S- by
o� IP LeuCsswr
zy
�0�n w1file LP_UCJSC_U'(— m
rsonally
me of person making statement
Known OR Produced Identification
Name of person making statement �O>�,
Personally Known OR Produced Identification _
pe'of
°Produced)--L
Identification
'DO TvA I -Is `! `
Type of Identification r x
Produced x--L
61
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y
J
Lure
an of Notary Public- State of Florida)
`( ignature of Notary Public- State of Florida) c
-n r�
I ission No. �G 5 ( (Seal)
Commission No. 6615 a f (Seal)
R
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REV
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/12/17
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