HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date:ll aka `� Permit Number: 11-�TIS
Building Permit Application =62o18
Planning and Development services
SBuilding and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Aluminum
DR0E1riT a
Address: 17701 WAGONWHEEL LANE, FORT PIERCE, I f SCANNED
Legal Description: CARLTON COUNTRY ESTATES LOT 7 BY
01 ucieCounty
Property Tax ID#: 3211-701-0009-000-2 Lot No. 7
Site Plan Name: Block No.
Project Name: WILLIAMS
Setbacks Front NL Back: 3141 Right Side: 176.6' Left Side: 173.5�
Itiona work o e orme una er is perm -c ec a app y:
0HVAC LiGasTank ❑Gas Piping _Shutters ❑Windows/Doors
Electric IJ Plumbing Sprinklers [] Generator Roof Roof pitch
Total Sq. Ft of Construction: _ $ Ft. of First Floor:
Cost of Construction: $ �, oZ IU.�-- Utilities:U$ewer Septic Building Height:
t.
Name KENNETH AND JOSEPHINE WILLIAMS
Name: )10.4
Address: 17701 WAGONWHEEL LANE
Company:`L
City: FORT PIERCE State: FL
Address:
Zip Code: 34945 Fax:
City: W4�i_ State: �L
Phone No. -�oZ
�,�1
Zip Code: Fpic: / lo�- 3�iJ
E-Mail:
Phone No. -711-3LL-A "
Fill in fee simple Title Holder on next page (if different
E-Mail: I0 �C f I Cyv
State or County License:
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
Wcarvivcnl=rvauv=cn: _ Ivor Hppncaole MORTGAGE COMPANY: t-Not Applicable
Name: Name:
Address: ((in.3 Address:
City: State: _ City: State: _
Zip: Phone, - Zip: Phone:
FEE SIMPLE TITLE HOLDER: ✓Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit
St. Lucie Counttyy 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 Inypur paying twice for
improvements to your property. A Notice of Commencement must b corded an osted on the jobsite
before the first inspection. If you intend to obtain financing, consul h lender attorney before
commencin work or re9cordin our Notice of Commencement.
Signature of Owne /Lessee/ ontractor as Agent for Owner Slgnat�re of Contr< or erise Holder
STATE OF FLORMLI,) �/� STATE OF
COUNTY OF /I 1 ��j COUNTYOF FLORIDA.7r� ` "kG('e
The for oing instr to w s ach owledge before me The forgoing instrument was acknowledged before me
this, day of,m�_, 20 �by this' a1 day of N l dyelrn %r' , 20 1L by
(Name of person acknowledging) (Name of person ckn wledging )
(Sign 11
a of Notary Public- Sta8.11if Florida) (Signature Notary Public- State of Florida )
Personally Known OR Prcquc d Ident+'fication Personally Known V OR Produced Identification
Type of Identification Produced 1 Vel I I04kl�. Type of Identification Produced
Commission No a �.. AN doRSOM-aIRMINGHAM Commission No. C C� •� �{ 1 fggg
. .�,. Not ry lic - state of Florida Commission # GG 249625 dee through National Notary Assn.
Revised 07/15/2014
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