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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _ Date: aI �6 Permit Number: RECEIVIED FEB 162016 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: 3120 Duban Terrace Legal Description: Silver Lake Park Addn Blk 11S 12ft.of Lot 7 and all of Lot 8 (or 1955-2848) Property Tax ID#: 2427-603-0152-000-8 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: Replacing Roof drys �^�vc,Q V2 v 0-/C CONSTRUCTION INFORMATION: Additional work toe nertormed under tispermit—c ec a appy: ❑HVAC Gas Tank Gas Pi _ Windows /Doors Piping Shutters Doors❑ / 11 Electric ❑ Plumbing ❑Sprinklers ❑Generator FV(] Roof Total Sq.Ft of Construction: 1152 S Ft.of First Floor: Cost of Construction:$ 2350.00 Utilities:Sewer❑Septic Building Height: OWNER/LESSEE CONTRACTOR: Name Randy Thomas Name: Address:3575 Sneed Road Company:I/124-hz_1J 9 Lam,., 7L1Ac:f2d.,- � City: Ft. Pierce State:FL Address: Zip Code: 34945 Fax:772-461-6668 City: est .^CCS State:FL Phone No.772-461-6228 Zip Code: 3 9X7 Fax: E-Mail:awrinc@hotmail.com Phone No. Fill in fee simple Title Holder on next page(if different E-Mail: from the Owner listed above) State or County License: If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. 1 a IDEMSIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable ame: �/ c��v�r chi,{� �e Name:,., . Haaress: �O G 7 a wale ffv� Address: City: �t—�er�e , State: City: State: Zip: 3 ygs© Phone Zip: Phone: FEE SIMPLE TITLEHOLDER: _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 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. Signatur of Owner/Lessee/Contractor as Agent for Owner Signatuiq of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 5-Y R COUNTY'OF 5•V. 'L The for oing instrument was acknowledged before me The forgoing.instr mnt was acknowledged before me this UP day of 20 .by this•% day of 20AG by 6,1 .r..a r, V \\ v`d,r b o.y w.o n c� y \1°�r o v q (Name Of person acknowledging) (Name-of person acknowledging) (Signature of Notary Pu lic-State of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produced I. N r t , .naa Personally Known OR P du�edtl� 1pwo Fes_ Type of Identification DPN. S,a�e �6 20 Type of IderifiCatlon E pub�� pec Produced '�L-Q L, pUb\�c:�\cesDec 5a�6� Produced L L a-sem .... 'Nota�omfi. ^ � ... 'No�amm.ES o�#E a N°ta<y Pssc u =:/ �< '_� �omm�ssl ti�au�11o1acy - PUO Commission No. L +.:�'y dYhNa�`0s Commission No. 'i`EvS�E1. - \ ° E f . � �, fir.✓ REVIEWS FRONT "�CLONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEWREVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.