HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST-BE COMPLETED ..APPLICATION TO BE ACCEPTED t
Date: //] r�a Permit Number: 566 "0_13 7
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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: ��p, 0 1 °'� �-� `' '�e-
V0� 3—��; 1�
PROPOSED IMPROVEMENT LOCATION:.
Address: 9609 Landings Drive Port St Lucie FL 34986
Legal Description: Fairway Landings parcel 10 Lot 1
Property Tax ID#: 3322-500-0023-000-0 Lot No.1
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: "
S V0,A Goo �-�•��rti.-� 1 cam- ��(�
CONSTRUCTION INFORMATION:
itiona workto e e e un er t is per —c ec a app y:
HVAC _Gas Tank Gas Piping Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S . Ft. of First Floor-
Cost of Construction: $ 695.00 Utilities: Sewer Septic Building Height:
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OWNER/LESSEE: . CONTRACTOR:
Na ,.Name: RobertBinkowski,..
Address:960,9 Landings..Drive �1 Company:Energized Gas;;
City: PortST`Lucie, State:FL Address: 645 NW.Enterpris`e'Drive#107
Zip Code: 34986Fax:':` City: Port.ST,Lucie,,_-. State:FL
Phone No.586-863-7585 :,_ Zip Code: 34986 Fax: 7728074565
E-Mail: Phone No. 7728074566
Fill in fee simple Title Holder on next page(if different E-Mail: Energized@bellsouth.net
from the Owner listed above) State or County License: 34747
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION`
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: 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 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 our Notice of Commencement.
X253� "::� s
_Signature of Owner/Lessee/Agent Signature of Contractor icense Holder
STATE OF FL O R�tSTATE OF FLORIDA
COUNTY OF COUNTY OFsaintlucie
The f r oing instru nt was knowledge afore me The forgoing instrument was acknowledged before me
this day of 20 Uby this a day of June 20 by
1 0'AhLLL �," Robert Binkowskl � J 4
(Name of ,erso ac now ledging (Name of pe on acknowledging)
I �W
nature of Notary P E ic- to of Florida) (Signature of Notary Public-State Florida)
Personally Known OR Produced Identification Personally Known x OR Produced Identification
Type of Identificati n Produced Type of Identification Produced
Commission No. ,�"'� ublic nate of Florida ommission No. ,
Antonia M Pauid
v • My Commission c` 191201yfN Notary Public Stats of F11i ,
My COMMIssion FF 191 -1
Revised 07/15/2014 ' '•ort►di Expireao2227/2019
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMP LETE
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