HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3/15/16 Permit Number: ILD
LS.100 LF
Building Permit Applicatidn
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: 121 NE Naranja AveJ.
Legal Description: j
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Property Tax ID#: 3419-530-0206-000-7 Lot No.20
Site Plan Name: Frend Residence J.., Block No. 39
Project Name: Frend Residence
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTIONCIF WORK:
Driveway replacement & extension----
PS1: 25001b
Thickness: 5 inches
Type: Fibermesh
CONSTRUCTION INFORMATION:
Additional work to be nertormed under t ispermit-check all appy:
HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
Electric ❑ Plumbing Sprinklers E]Generator !]Roof
Total Sq. Ft of Construction: S . Ft.of First Floor! J'
Cost of Construction:$ Utilities: _Sewer[]Septic Building Height:
OWNER/LESSE,E: CONTRACTOR`'
NameLexis l sdu x- Name:
Address:121 NE Naranja Ave Company:
City: Port St. Lucie State:FL Address: !
Zip Code. 34983 Fax: City: � �' State:
Phone No.561-628-4978 Zip Code: i! Fax:
E-Mail:LKFrend@yahoo.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: r
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If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION 4'
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DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
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FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
Name: Name: l
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
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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.
C�LI
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_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF PkL1n B ex- G4,, COUNTY OF
The forgoing instrument was a knowledged before me The forgoing instrument was acknowledged before me
this_LSday of 20 Lj&by this day of 20 by
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(Name of erson ac nowt dging) (Name of person acknowledging)
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Vi a re of No Ary Public-State of Florida ) (Signature of Notary iPublic-State of,Florida )
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Personally Known_ OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No.FF9(o.SS"/� (Seal) C i n No. I' (Seal)
o�►R* Nota��.b
Stat of Florida
c� My Commission FF 865817
Revised 07/15/2014 - 'lo,V_v Expireso31o61202o
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION li SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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