HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �'\
Date: 7/6/15 Permit Number: /Rn ' o �SS�
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
PROPOSEp IMPROVEMENT LOCATION
Address: 6110 CASSIA DRIVE
Legal Description: LOT 1 BLOCK 94 IRE UNIT 9
Property Tax ID#: 3402-610-0639-000-4 Lot No. 1
Site Plan Name: Block No. 94
Project Name: EASY STREET PROJECT-WATER HOOK-UP
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION
Installing water line - City of Port St. Lucie Utility Sytems
CONSTRUCTION INFORMATION
..
itional work toa nertormed under this permit—check all apply:
❑HVAC 0 Gas Tank ❑Gas Piping _Shutters Windows Doors p g ❑Windows/
Doors
21 Plumbing Sprinklers E]Generator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ 544.00 Utilities:]Sewer 0 Septic Building Height:
'OWNER/'LESSEE �', �.' , :. . CONTRACTOR
Name Thomas Kiernan Name: City of PSL- Utility Systems
Address: 6110 Cassia Drive Company:
City: Port St. Lucie State: FL Address: 900 SE Ogden Drive
Zip Code: 34982-3748 Fax: City: Port St. Lucie State:FL
Phone No.772-216-3830 Zip Code: 34953 Fax: 772-873-6405
E-Mail: Phone No. 772-873-6400
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: 25597
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPLEMENT CONSTRl1CT10N LIEN LgU1/ INEORMATION� y f
F r
y ,
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
commencin r r recording our Notice of Commencement.
I
s
_Signature of Owner/Les a/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Sl.Lucie COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this ( day of JGc( 20 /5 by this day of 20 by
lUAIVrEL StGu
(Name of person acknowledging) (Name of person acknowledging)
(Sig ure of Notary Public-itate of Florida) (Signature of Notary Public-State of Florida)
Personally Known ✓ OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
JEANETTE TiHOMPSON
Commission No. NOTfAA PUBLIC Commission No. (Seal)
STATE OF FLORIDA
Comm#EE643265
ONNIV Expires 10/14/2016
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
JINITIALS