HomeMy WebLinkAboutBuilding Permit Application 11/12/2015 THU 11: 22 FAX 2002/004
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11/12/2015 Permit Number: 5 �a�
'} RECE11'ED NOV 12 2015
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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: To Select from dropbox, click arrow at the end of line'�V ilac
Address: 2968 Eagles Nest Way
Legal Description: EAGLE'S RETREAT AT SAVANNA CLUB PHASE 2 (PB 43-21)BLK 62 LOT 4(OR 2336-1038)
Property Tax ID#: 3424-702-0123-000-4 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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Additionalwork to be performed under this permit—check all appy:
Z✓ HVAC Gas Tank []Gas Piping _Shutters a Windows/Doors
Electric 0 Plumbing Sprinklers Generator E]Roof
Total Sq. Ft of Construction: TFt of First Floor:
Cost of Construction:$ 5640.00 UtilitiesSewer Septic Building Height:
„,h,.,.
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Name Christian&Elizabeth Clausen Name: Robert Brown
Address:2968 Eagles Nest Way Company: Smith Services
City: Port St Lucie State:FL Address: 1306 29th street
Zip Code: 34952 Fax: City: Vero Beach State:FL
Phone No. Zip Code: 32960 Fax: 772-299-4994
E-Mail: Phone No. 772-770-3300
Fill in fee simple Title Holder on next page(if different E-Mail: Frances_Brown@smithservices.org
from the Owner listed above) State or County License: CACI 816178
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
11/12/2015 THU 11: 23 FAX 12003/004
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x 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 thepermit 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 th irst inspection. If you intend to obtain financing,,_,Co.n&9It with lender or an attorney before
com nci w rk or recpfd-ipg your Notice of Commencement./
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_Signature of Owner/Lessee/Agent ignature of Contractor License Holder
STATE OF FLORIDA �` STATE OF FLORIDA
COUNTYOF `�,a1�yP,r �`�y2(' COUNTY OF Z\,Va
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of20 Eby this day of�(�1P�n%.N3" 20 LL by
V-D
(Name of person acknowledging) (Name of person acknowledging)
(Signat e o otary Public State of Florida} (Signature No ry Public-Stat f Florida)
Personally Known k-'--OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No.VTba0N0 mission NoXy 3CDla (Seal)
*'Py'•., JOYCE MICHAUD
MY COMMISSION FF 0830D o Y'+° JOYCE MICHAUD
,. ,=_ MY COMMISSION#FF 083008
Revised 07/15/2014 s;t BendedThruNotaryPubrcUndarvrrtars EXPIRES:Apol25,2018
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
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DATE
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