HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:, Permit Number: 100) " 0 3333
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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
PROPOSED IMPROVEMENT.LOCATION: .
Address: 8106 COQUINA AVE, FORT PIERCE
Legal Description: LAKEWOOD PARK-UNIT 8-BLK 92 LOT10(MAP 13/02N)(OR 3827-2192)
Property Tax ID#: 1301-608-0113-000-8 Lot No.10
Site Plan Name: Block No. 92
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED'D,ESCRIPTI,ON OF, ORK:
DEMOLISH POOL, FILL WITH SAND
CONSTRUCTION.I N FORMATION
Additional work to be performed under this permit—check all appy:
HVAC Gas Tank Gas Piping _Shutters Q Windows/Doors
11 Electric Plumbing Sprinklers E Generator Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 1900.00 Utilities:0Sewer Septic Building Height:
:OWNER/LESSEE. CONTRACTOR:
Name Gloria Bozzini Name: JOHN O'CONNELL
Address:8106 Coquina AVE Company: JOHN OCONNELL INC
City: Fort Pierce, FL 34951-1032 State:_ Address: 11005W MIDWAY RO
Zip Code: Fax: City: FORT PIERCE State:FL
Phone No.954-591-9444 Zip Code: 34945 Fax:
E-Mail: Phone No. 772-461-4483
Fill in fee simple Title Holder on next page(if different E-Mail: JOHNOCONNELLDEMO@BELLSOUTH.NET
from the Owner listed above) State or County License: 22089
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL.CONSTRUCTION LIEN=LAIN 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
comMncing work or recording our Notice of Commenceme t.
s
_Signature of Owner/Lessee/ gent S!Oture of Contractor/License Holder
STATE OF FLORIDA STATE OF
COUNTY OFA, COUNTY OF-
T
F FLORIDA,:,,, L Ali•:
Theflor�oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this' day of n 20 (�by this 12K day of 20/& by
(Name of person acknowledging) (Name of person acknowledging)
1-4ign�gtaure of NotaLryPu&ILI State of Florida) (Signatureof ry Public-State of Florida)
Personally Known OR Produced Identificatio Personally Known (/ OR Produced Identification
Type of Identification Produced Type of Identification Produced
1.r°� STAGY HENDERM
Commission N , (Seal) Commission No. 2°••' BA1)
* * MY COMMISSION t FF 177
_``.pr x`�= Notar SHAH i.4i'Jl rr EXPIRES:November 17,2
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M of Florida eF�
9� �`� ymmi Fxprres Dec 20,2018
Revised 0 15�, Cossron//FF 177
• Bonded;'h;,;uM�nr ;, 249 t
arYAssn.
REVIEWS FRONT ZONING ASO E VISOR PLANS VEGETATION SEA TURTLE MANGROVE.
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
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