HomeMy WebLinkAboutBuilding Permit Application APR/20/2015/MON 11 :21 AM AAS Rescue Rooter FAX No, 772-794-9783 P, 001
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ✓ f1���
Crate: Permit Number:
Building Permit Application
Planning and Development Services
Building 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: To Select from dropbox, click arrow at the end of line
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Address: 8111 S Indian River Dr, Fort Pierce,FL 34982
Legal Description: 18 36 41 THAT PART OF N 110 FT OF S 802.69 FT OF GO\rr 1.OT 3 LYGW OF A L1300 FT W OF AND 11 TO W RM LI OF S IND RIV OR AND E
OF FEC RR AND ALSO N 109.11 FT OF S 692.89 FT OF LOT 3 LYG E OF FEC RR-LESS IND RIV DR-(3.68 AC)(OR 3558-2457)
Property Tax ID 4: 3518-311-0003-000-5 Lot No.
Site Plan Name: Norman Liddell Block No.
Project Name: Norman Liddell
Setbacks Front Back: Right Side: Left Side:
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orme un er ils permit—c ec a appy:
OHVAC ❑Gas Piping _1:1Shutters ❑Windows/Doors
11 Electric ❑Plumbing Sprinklers 11 Generator Roof
Total Sq. Ft of Construction: SFt. n
of First Floor:
Cost of Construction:$ 13,900.00 Utilities:11 Sewer 1.�I Septic Building Height:
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Name Norman Liddell Name: Dennis Zacek
Address;8111 $Indian River Dr Company: American Residential Services
City. Ft Pierce State:FL Address: 2800 US Hwy 1
Zip Code: 34982 Fax: City: Vero Beach State:Fl,
Phone No.(772)828-1580 Zip Code: 32960 pax: (772)7949783
E-Mail: Phone No. (772)794-7221
Fill in fee simple Title Holder on next page(if different E-Mail: dzacek@ars.com
from the Owner listed above) State or County License: CM01249753
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
APR/20/2015/MON 11 :21 AM ARS Rescue Rooter FAX No. 772-794-9783 F. 002
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DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name.' NIA Name: N/A
Address: Address—:
City: State: City, State:
Zip: Phone- Zip: Phone:
FEE SIMPLE TITLE HOLDER; _Not Applicable BONDING COMPANY: —Not Applicable
Name: N/A Name: NIA
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has Commenced prior to the issuance of apermit.
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 permit that may restrict or prohibit such
structure.Please consult with your 14orne 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 your Notice of Commencement.
—Signature of Owner/Lessee/Agent Signature of Contractor4teense Holder
STATE OF FLORIDA STATE OF FLORIT
COUNTY OF COUNTY OF s�, I-I-X-je C), V-?+-i
If—
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this_day of 20 by this A20day of a 20 _L-'
I by
Dends Zscek
f person kn ed in
(Name of person acknowledging) (Name of
owl Vz
(Signature of Notary Public-State of Florida) (Signa re of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Produced Type of identification Produced
Commission No. (seal) Commission Noj� �'� (Seal)
Revised 07/15/2014 Notary puttle- 01 Florida MY I
oornrn.2-Ap-ties Apr 26 201
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