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HomeMy WebLinkAboutBuilding Permit Application ALL APPLldABLE`INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 Date: �1\G;11 Permit Number: RECEIV'SD FEB 16 2016 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: 3114 Duban Terrace Legal Description: Silver Lake Park Addn Blk 11 S 24%of Lot 6 and N48%of Lot 7(or 1920-1765) Property Tax ID#: 2427-603-0150-000-4 Lot No. Site Plan Name: Block No. Project Name:, Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OFWCOK Replacing Roofj'Y1 �v0 Y/1 A CONSTRUCTCO'N INFORMATION Additionalworkto e e orme under't is permit-check all Mat appy: " ❑HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors ❑Electric , Plumbing Sprinklers Generator IZI Roof Total Sq.Ft of Construction: 1152 S . Ft.of First Floor: Cost of Construction:$ 2350.00 Utilities:n Sewer E]Septic. Building Height: OWNER% DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable Name:01a Ic "uGrr�_ Name: _Adores__.s,_o� Ahnresc .---- —_--- -------- :1 City: ; State:� City: State: Zip: c�gs© Phone �G o -7 °7 s/ Zip: Phone: FEE SIMPLE TITLE-HOLDER: =Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City. Zip: Phone: Zip: Phone: OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that no workor 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. Signatur o Owner/Lessee/Contractor as Agent for Owner Signatutgof Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 5-S- COUNTY OF 1-3c'%$k, The for oing instrument was acknowledged.before me The forgoing.instr m nt was acknowledged before me day of .20 'r by this 1Co. aay.of .20A G by (Name of person acknowledging) (Name.of person acknowledging) (Signature of Notary Pu lic-State of Florida) (Signature of Notary Public-State of Florida) VEN Personally Known OR Produced ' .02' Personally Known OR Proe(�red° Type of Identification O�PN S\a�e��g;2o Type of Id`e ification y �~'`_, o�a�y p�b�`c : be.g16_ Produced Y L ,Jesoe 5a�6�` Produced L- t— '> �sp°#kms No\aNPSS� Commission No. ��L .MY doa9bNai�o Commission No. ICE�5. REVIEWS FRONT :. I ONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW` REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.7/2014