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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLIBL NFO MUST BE COMPLETED FOR APP;ICp,TIONSu BE ACCEPTED Date: /2017 BY Permit Number: St. Lucie County Building Permit Application F" 2 20jg Planning and Development Servicesi Building and Code Regulation Division L Lucie County, Pern 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential PERMIT APPLICATION FOR: -ate ���a\ buil�►wd PROPOSED IMPROVEMENT LOCATION: Address: Legal Description: Central White City S/D Elk 3 Lots 9, 10, and 11 Property Tax ID #: 3403-804-0037-000-2 Site Plan Name: Project Name: m Setbacks Front (D l'A Back: 4� o Right Side: 1;13 Left Side: k 0 0'Z Lot No. Block No. DETAILED DESCRIPTION OF WORK: III _rr0a-1 l me*o_k bu.' l di n9 i CONSTRUCTION IN LJHVAC LJ Gas Tank 1-1 Electric Plumbing 0qU)(s(3x )o Fr,c.\( *moo Pl Mbnq (-�o irn9 Piping UShutters ❑Windows/Doors nklers 1:1Generator ©Roof )F il Roof pitch Total Sq. Ft of Construction: db S Ft. of First Floor: 3�u Cost of Construction: $ (�Q� Utilities: Sewer Septic Building Height: (oi • 1 �} OW N ERAESSEE:` CONTRACTOR: Name Debra fasnacht Name: Address: 009 Lace Ave. Company:(1`('Qois awuoh-P,rf�. Inc, City: Fort Pierce State: FL Zip Code: 34982 Fax:774-489-2703 Phone No.772-489-3771 Address: Y© Q)m —1-1 le City: '111 - State: �) Zip Code: 3@zA1 Fax: Phone No._`Jc_)-Lkk02_ � e E-Mail: hardscapepavers@aol.com Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail: c C't`l�� State or County License: I IgC1 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: T- Not Applicable Named {y)(k\het3 (_10`wtn MORTGAGE COMPANY: Name: _ Not Applicable Address: mob P6voke rood Address: City: Zip: Phone: State: City: F-H�--o(A4rvd State: R Zip: 341-1ao Phone 58U0 11 I-85-if; FEE SIMPLE TITLEHOLDER: _ Not Applicable Name: BONDING COMPANY: Name: _Not Applicable 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 commencing work or,recording Vour Notice of Commencement. Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of C actor/License Holder STATE OF FLORIDA COUNTY OF — STATE OF FLORIDA /I1� -1 COUNTY OFFY F]Cit pt The forgoing instrument was acknowledged before me The forgoing instCument was acknowledged before me this 20 day of N�emne 20_ by this day of X'An Q 20_Z by L)ehrr, )PM -es WIGS.-M r Name of person making statement Name of person rNaking statement Personally Known x OR Produced Identification Personally Known i OR Produced Identification Type of Identification Type of Identification Produced Produced 4 CLO- (Signature of Nof&y Pub! i -S>< on ignature of Notary Public -State of Florida W DY G JERNIG FF1slsas "1 ` Mf50®I']1MISSION N •••••,•• IA pill WELSH (�$` Commission No. ,+ 1 #FF1sle eC mmission No. SSION0GGt •'" MY I EXPIRES September 2t, 201 s I7fPIRES May pg, 2021 IdnYlIIA6•0183 FlarldMlolaryservloe.com REVIEWS ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE FRONT COUNTER REVIEW REVIEW REV EW REVIEW REVIEW REVIEW DATE p RECEIVED DATE COMPLETED Rev.8/2/17